Individual
CANDICE YVONNE GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS
Contact information
Practice address
1606 WELLINGTON AVE UNIT C, COMMUNITY SUPPORT PROFESSIONALS,LLC, WILMINGTON, NC 28401-7704
(910) 799-4505
(910) 799-4345
Mailing address
4321 TILLSON ROAD, WILMINGTON, NC 28412
(770) 722-4882
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1759
NC
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1759
NORTH CAROLINA SUBSTANCE ABUSE PRACTICE BOARD
NC
Enumeration date
09/18/2009
Last updated
04/10/2013
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