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NPI Code Detail

MEDICARE: CANDICE WU LPC

MEDICARE: CANDICE WU LPC
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
1101Y00000XCounselor178010564IL

General Provider Information

NPI Number : 1275947566
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDICE WU LPC
Provider Business Mailing Address
First Line : 1616 W BALMORAL AVE APT 3W
Second Line :
City : CHICAGO
State : IL
Zip : 60640-1155
Country : US
Telephone Number : 248-390-5001
Fax Number :
Provider Business Practice Location Address
First Line : 4050 N LINCOLN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-3067
Country : US
Telephone Number : 248-390-5001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2014
Last Update Date : 12/14/2014

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Directions to “ CANDICE WU LPC” Practice Location

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