MEDICARE: CANDACE ANNE MORIN MS, LMFT, LMHC

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
1	101YM0800X	Mental Health Counselor	MH 4952	FL
2	106H00000X	Marriage & Family Therapist	MT 1670	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467627091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDACE ANNE MORIN MS, LMFT, LMHC

Provider Business Mailing Address
First Line	:	8695 COLLEGE PKWY
Second Line	:	SUITE 252
City	:	FORT MYERS
State	:	FL
Zip	:	33919-4890
Country	:	US
Telephone Number	:	239-489-4705
Fax Number	:	239-489-2732

Provider Business Practice Location Address
First Line	:	8695 COLLEGE PKWY
Second Line	:	SUITE 252
City	:	FORT MYERS
State	:	FL
Zip	:	33919-4890
Country	:	US
Telephone Number	:	239-489-4705
Fax Number	:	239-489-2732

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2008
Last Update Date	:	04/24/2008

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