Provider Demographics
NPI:1487214755
Name:DICANDIA, STEPHANIE (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:DICANDIA
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-2104
Mailing Address - Country:US
Mailing Address - Phone:908-303-1971
Mailing Address - Fax:
Practice Address - Street 1:1000 HERRONTOWN RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-7716
Practice Address - Country:US
Practice Address - Phone:609-285-3840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00606100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional