Individual
CANDICE M SCOVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, SAC-IT
Contact information
Practice address
514 RIVERVIEW AVE, WAUKESHA, WI 53188-3631
(262) 548-7666
Mailing address
514 RIVERVIEW AVE, WAUKESHA, WI 53188-3631
(262) 896-8051
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
20171-130
WI
101YM0800X
Mental Health Counselor
Primary
10560-125
WI
Other
Enumeration date
01/19/2022
Last updated
02/12/2025
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