Provider Demographics
NPI:1811070204
Name:CANDRIAN, LORI T (LPC)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:T
Last Name:CANDRIAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:LYNNE
Other - Last Name:TOWNSEND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:107 E SEALY ST
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-2440
Mailing Address - Country:US
Mailing Address - Phone:281-585-0000
Mailing Address - Fax:281-585-0080
Practice Address - Street 1:107 E SEALY ST
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-2440
Practice Address - Country:US
Practice Address - Phone:281-585-0000
Practice Address - Fax:281-585-0080
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10296101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional