Provider Demographics
NPI:1467627091
Name:MORIN, CANDACE ANNE (MS, LMFT, LMHC)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:ANNE
Last Name:MORIN
Suffix:
Gender:F
Credentials:MS, LMFT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8695 COLLEGE PKWY
Mailing Address - Street 2:SUITE 252
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-4890
Mailing Address - Country:US
Mailing Address - Phone:239-489-4705
Mailing Address - Fax:239-489-2732
Practice Address - Street 1:8695 COLLEGE PKWY
Practice Address - Street 2:SUITE 252
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-4890
Practice Address - Country:US
Practice Address - Phone:239-489-4705
Practice Address - Fax:239-489-2732
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 4952101YM0800X
FLMT 1670106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health