Provider Demographics
NPI:1811397201
Name:CANDIDA BARBER, LPC PLLC
Entity Type:Organization
Organization Name:CANDIDA BARBER, LPC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CANDIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-255-6748
Mailing Address - Street 1:4913 N QUAPAH PL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-2562
Mailing Address - Country:US
Mailing Address - Phone:405-255-6748
Mailing Address - Fax:
Practice Address - Street 1:1019 WATERWOOD PKWY STE E
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-5329
Practice Address - Country:US
Practice Address - Phone:405-255-6748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4529101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty