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General NPI Number Information
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NPI Number | 1396613774
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Entity Type | Organization
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Legal Business Name | CANDICE I KEMBLE MCP LPC PLLC
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 400 E CENTRAL AVE
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City | PONCA CITY
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State | OK
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Zip | 74601-5429
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Country | US
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Telephone | 580-485-5814
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Fax |
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Provider Business Mailing Address
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Address Line | 430 S ELM ST
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City | PONCA CITY
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State | OK
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Zip | 74601-6001
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Country | US
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Telephone | 580-716-7206
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | CANDICE ILENE KEMBLE
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Credential | MCP, LPC
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Telephone | 580-716-7206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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