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NPI Code Detail

MEDICARE: CANDICE RAE WARNER MA, LLPC

MEDICARE: CANDICE RAE WARNER MA, LLPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor6401017036MI

General Provider Information

NPI Number : 1255905519
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDICE RAE WARNER MA, LLPC
Provider Business Mailing Address
First Line : 1001 FAIRFIELD DR
Second Line :
City : MOUNT PLEASANT
State : MI
Zip : 48858-4317
Country : US
Telephone Number : 989-954-4673
Fax Number :
Provider Business Practice Location Address
First Line : 1001 FAIRFIELD DR
Second Line :
City : MOUNT PLEASANT
State : MI
Zip : 48858-4317
Country : US
Telephone Number : 989-954-4673
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2021
Last Update Date : 01/14/2022

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Directions to “ CANDICE RAE WARNER MA, LLPC” Practice Location

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