Provider Demographics
NPI:1891756441
Name:NEWBURY, CANDACE (LMHC, LMFT, BCETS)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:NEWBURY
Suffix:
Gender:F
Credentials:LMHC, LMFT, BCETS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 TROY ST
Mailing Address - Street 2:SUITES 4 & 5
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3023
Mailing Address - Country:US
Mailing Address - Phone:508-676-5708
Mailing Address - Fax:508-676-1948
Practice Address - Street 1:66 TROY ST
Practice Address - Street 2:SUITES 4 & 5
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3023
Practice Address - Country:US
Practice Address - Phone:508-676-5708
Practice Address - Fax:508-676-1948
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1311101YM0800X
MA665106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICN16573Medicare ID - Type UnspecifiedRI MEDICARE PROVIDER NUMB