Provider Demographics
NPI:1790254480
Name:PAOLINO, CANDICE LYNNE (LPC)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:LYNNE
Last Name:PAOLINO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 BARES RUN DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-5901
Mailing Address - Country:US
Mailing Address - Phone:513-505-2445
Mailing Address - Fax:
Practice Address - Street 1:6722 STATE ROUTE 132 STE A
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:OH
Practice Address - Zip Code:45122-9346
Practice Address - Country:US
Practice Address - Phone:513-575-7879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-25
Last Update Date:2018-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1700659101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty