Healthcare Provider Details

I. General information

NPI: 1841125267
Provider Name (Legal Business Name): CANDICE STOLARZYK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 FRENETTE DR STE 7
CHIPPEWA FALLS WI
54729-3468
US

IV. Provider business mailing address

PO BOX 68
MENOMONIE WI
54751-0068
US

V. Phone/Fax

Practice location:
  • Phone: 715-235-1839
  • Fax:
Mailing address:
  • Phone: 715-235-1839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9068-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: