Healthcare Provider Details

I. General information

NPI: 1598004897
Provider Name (Legal Business Name): CANDACE L FINAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2013
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 W PORT PLAZA DR STE 326
SAINT LOUIS MO
63146-3214
US

IV. Provider business mailing address

PO BOX 81
NEW MELLE MO
63365-0081
US

V. Phone/Fax

Practice location:
  • Phone: 314-578-6629
  • Fax: 636-333-4510
Mailing address:
  • Phone: 314-578-6629
  • Fax: 636-333-4510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2005016666
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: