Provider Demographics
NPI:1760066062
Name:MITCHELL, CANDICE (MS,LGPC,NCC)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MS,LGPC,NCC
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:
Other - Last Name:MITCHELL FERINDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS,LGPC,NCC
Mailing Address - Street 1:11155 STRATFIELD CT # 21104
Mailing Address - Street 2:
Mailing Address - City:MARRIOTTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21104-1650
Mailing Address - Country:US
Mailing Address - Phone:443-934-1462
Mailing Address - Fax:
Practice Address - Street 1:11155 STRATFIELD CT
Practice Address - Street 2:
Practice Address - City:MARRIOTTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21104-1650
Practice Address - Country:US
Practice Address - Phone:443-219-5412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-12
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11470101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health