Individual
CANDICE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1500 HWY 287, BROOMFIELD, CO 80020-1160
(303) 438-8085
Mailing address
3381 W 147TH CT, BROOMFIELD, CO 80023-8706
(303) 438-8085
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11235
CO ACTIVE UNLICENSED PSYCHOLTHERAPIST
CO
01
—
6284141
AMERICAN COUNSELING ASSOCIATION
CO
Enumeration date
02/18/2010
Last updated
02/18/2010
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