Provider Demographics
NPI:1982156105
Name:DUE, CANDICE (LMHC)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:DUE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3786 HARRISON CROSSING LN
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-7616
Mailing Address - Country:US
Mailing Address - Phone:317-709-3402
Mailing Address - Fax:
Practice Address - Street 1:3786 HARRISON CROSSING LN
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-7616
Practice Address - Country:US
Practice Address - Phone:317-919-2138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-04
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003025A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health