MEDICARE: CANDACE E HYMAN LPC

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
1	101YM0800X	Mental Health Counselor	14348	TX

General Provider Information

NPI Number	:	1629275755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDACE E HYMAN LPC

Provider Business Mailing Address
First Line	:	7110 ALPHA RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-5526
Country	:	US
Telephone Number	:	972-233-7112
Fax Number	:	872-233-7114

Provider Business Practice Location Address
First Line	:	8222 DOUGLAS AVE STE 777
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75225-5938
Country	:	US
Telephone Number	:	972-761-9902
Fax Number	:	972-233-7114

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	07/08/2007

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