Provider Demographics
NPI:1437550381
Name:DICKINSON, CANDACE (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:DICKINSON
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 POWDERMILL RD # 209
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-5932
Mailing Address - Country:US
Mailing Address - Phone:508-571-8757
Mailing Address - Fax:
Practice Address - Street 1:8 LYMAN ST
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1487
Practice Address - Country:US
Practice Address - Phone:617-431-6140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-10
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health