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General NPI Number Information
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NPI Number | 1831344597
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Entity Type | Individual
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Provider Name | CANDICE PAGE STER LCSW, CAP, BCABA
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Gender | Female
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Dates
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Enumeration Date | 11/22/2008
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Last Update Date | 11/22/2008
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Provider Practice Location Address
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Address Line | 4300 MARSH LANDING BLVD SUITE 204
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-1416
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Country | US
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Telephone | 904-333-1924
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Fax |
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Provider Business Mailing Address
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Address Line | 3669 SEA HAWK ST E
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City | JACKSONVILLE
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State | FL
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Zip | 32224-2260
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Country | US
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Telephone | 904-887-0407
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 4426
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 0-01-0233
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW 8471
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License Number State | FL
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