Provider Demographics
NPI:1629534797
Name:BEGGS, CANDICE C
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:C
Last Name:BEGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:C
Other - Last Name:NEWMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LAC
Mailing Address - Street 1:923 S HONEYSUCKLE DR
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81007-6308
Mailing Address - Country:US
Mailing Address - Phone:719-289-5959
Mailing Address - Fax:
Practice Address - Street 1:511 W 29TH ST
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-1128
Practice Address - Country:US
Practice Address - Phone:719-289-5959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACA.0007735101YA0400X
COACA0001865101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)