Provider Demographics
NPI:1295944569
Name:FEDERICO, CANDICE MARIA (LMHC, CAP)
Entity type:Individual
Prefix:MS
First Name:CANDICE
Middle Name:MARIA
Last Name:FEDERICO
Suffix:
Gender:F
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P. O. BOX 3281
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-3281
Mailing Address - Country:US
Mailing Address - Phone:561-676-3488
Mailing Address - Fax:561-279-2898
Practice Address - Street 1:801 SE 6TH AVE
Practice Address - Street 2:STE 206 & 202
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5185
Practice Address - Country:US
Practice Address - Phone:561-279-2080
Practice Address - Fax:561-279-2898
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1973101YA0400X
FLMH 5131101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health