Individual
COREY A CANDELARIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, M.A. CSPT, CSAT
Contact information
Practice address
1068 S 88TH ST, UNIT A, LOUISVILLE, CO 80027-9461
(303) 917-3114
(303) 763-1871
Mailing address
1068 S. 88TH STREET, UNIT A, LOUISVILLE, CO 80027-2444
(303) 917-3114
(303) 763-1871
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
5569
CO
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
5569
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5569
LPC
CO
Enumeration date
12/08/2007
Last updated
01/24/2017
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