Provider Demographics
NPI:1760922892
Name:CONROY, CANDICE (LMHC)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:CONROY
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 1:1384 LAKE BALDWIN LN APT B
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6667
Mailing Address - Country:US
Mailing Address - Phone:407-603-6132
Mailing Address - Fax:
Practice Address - Street 1:1384 LAKE BALDWIN LN APT B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6667
Practice Address - Country:US
Practice Address - Phone:407-603-6132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14280101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health