Healthcare Provider Details

I. General information

NPI: 1881353563
Provider Name (Legal Business Name): CANDACE PASTURES-BROWN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2021
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CADMAN PLZ W
BROOKLYN NY
11201-3229
US

IV. Provider business mailing address

418 BROADWAY
ALBANY NY
12207-2922
US

V. Phone/Fax

Practice location:
  • Phone: 518-541-1598
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number017620
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: