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NPI Code Detail

MEDICARE: CANDY ANN VANDEVELDE LPC-S

MEDICARE:   CANDY ANN VANDEVELDE  LPC-S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor4328LA

General Provider Information

NPI Number : 1144696170
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDY ANN VANDEVELDE LPC-S
Provider Business Mailing Address
First Line : 109 YORKTOWN DR STE A
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71303-3673
Country : US
Telephone Number : 318-277-6686
Fax Number :
Provider Business Practice Location Address
First Line : 109 YORKTOWN DR STE A
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71303-3673
Country : US
Telephone Number : 318-277-6686
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2015
Last Update Date : 12/15/2021

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Directions to “ CANDY ANN VANDEVELDE LPC-S” Practice Location

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