Provider Demographics
NPI:1932543337
Name:MARSHALL, CANDICE G (LPC)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:G
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7715 TRESTLEWOOD DR
Mailing Address - Street 2:APT 3B
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-8797
Mailing Address - Country:US
Mailing Address - Phone:313-330-1221
Mailing Address - Fax:
Practice Address - Street 1:7715 TRESTLEWOOD DR
Practice Address - Street 2:APT 3B
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-8797
Practice Address - Country:US
Practice Address - Phone:313-330-1221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional