Healthcare Provider Details
I. General information
NPI: 1639664758
Provider Name (Legal Business Name): CANDACE RICHEY LPC, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/30/2018
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1115 ELKTON DR STE 202
COLORADO SPRINGS CO
80907-3599
US
IV. Provider business mailing address
PO BOX 64002
COLORADO SPRINGS CO
80962-4002
US
V. Phone/Fax
- Phone: 719-963-2927
- Fax:
- Phone: 719-963-2927
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | ACD.0001278 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | LPC.0016263 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: