Provider Demographics
NPI:1780250514
Name:MCMANN, CANDACE (LCPC)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:MCMANN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11021
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59719-1021
Mailing Address - Country:US
Mailing Address - Phone:406-781-7468
Mailing Address - Fax:
Practice Address - Street 1:2066 STADIUM DR STE 201
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-0640
Practice Address - Country:US
Practice Address - Phone:406-333-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-57487101YM0800X
MTBBH-PCLC-LIC-49099101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health