Provider Demographics
NPI:1689267494
Name:MITCHELL, CANDICE (LMHC)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1631 DEL PRADO BLVD. S SUITE 300
Mailing Address - Street 2:#1133
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-7549
Mailing Address - Country:US
Mailing Address - Phone:239-789-0971
Mailing Address - Fax:
Practice Address - Street 1:2656 MARAVAL CT
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-3154
Practice Address - Country:US
Practice Address - Phone:239-789-0971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-12
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23557101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health