Provider Demographics
NPI:1891318101
Name:GARCIA, CANDACE MICHELLE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:MICHELLE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 BLUESTAR DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-3317
Mailing Address - Country:US
Mailing Address - Phone:432-701-1035
Mailing Address - Fax:
Practice Address - Street 1:5120 BLUESTAR DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-3317
Practice Address - Country:US
Practice Address - Phone:432-701-1035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0019666101YP2500X
NMCTB-2022-0299101YP2500X
TX77574101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional