MEDICARE: CANDICE G. MARSHALL 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	101Y00000X	Counselor	6401013278	MI
2	101YP2500X	Professional Counselor	6401013278	MI

General Provider Information

NPI Number	:	1932543337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDICE G. MARSHALL LPC

Provider Business Mailing Address
First Line	:	7715 TRESTLEWOOD DR
Second Line	:	APT 3B
City	:	LANSING
State	:	MI
Zip	:	48917-8797
Country	:	US
Telephone Number	:	313-330-1221
Fax Number	:

Provider Business Practice Location Address
First Line	:	7715 TRESTLEWOOD DR
Second Line	:	APT 3B
City	:	LANSING
State	:	MI
Zip	:	48917-8797
Country	:	US
Telephone Number	:	313-330-1221
Fax Number	:

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

Provider Enumeration Date	:	04/29/2013
Last Update Date	:	03/27/2026

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