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General NPI Number Information
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NPI Number | 1861680043
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Entity Type | Individual
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Provider Name | CANDYCE V CONNER M.S., LPC
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Gender | Female
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Dates
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Enumeration Date | 10/12/2007
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Last Update Date | 10/12/2007
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Provider Practice Location Address
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Address Line | 6601 PHILBROOK RD
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City | RICHMOND
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State | VA
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Zip | 23234-6228
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Country | US
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Telephone | 804-502-9847
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Fax | 804-743-0084
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Provider Business Mailing Address
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Address Line | PO BOX 37492
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City | RICHMOND
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State | VA
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Zip | 23234-7492
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Country | US
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Telephone | 804-502-9847
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Fax | 804-743-0084
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701004235
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License Number State | VA
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