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Individual

CANDICE SHIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
511 WALNUT AVE, COLONIAL HEIGHTS, VA 23834-2835
(804) 601-8553
(804) 979-0373
Mailing address
7410 HULL STREET RD STE 200, NORTH CHESTERFIELD, VA 23235-5834
(804) 601-8553
(804) 979-0373

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
Primary
0904017396
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30018025690001
VA
Enumeration date
11/03/2020
Last updated
04/22/2025
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