Provider Demographics
NPI:1447599063
Name:ASHLEY, CANDICE R (M ED, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:R
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:M ED, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12407 FM 39 S
Mailing Address - Street 2:
Mailing Address - City:NORMANGEE
Mailing Address - State:TX
Mailing Address - Zip Code:77871-3780
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1401 SANDIA PLZ
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-4356
Practice Address - Country:US
Practice Address - Phone:903-388-6781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66496101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional