Provider Demographics
NPI:1063980639
Name:BROWNC, CANDYCE
Entity type:Individual
Prefix:
First Name:CANDYCE
Middle Name:
Last Name:BROWNC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CANDYCE
Other - Middle Name:
Other - Last Name:MAYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLEETWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19522-1323
Mailing Address - Country:US
Mailing Address - Phone:610-944-0445
Mailing Address - Fax:610-944-8834
Practice Address - Street 1:90 S COMMERCE WAY STE 300
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-8611
Practice Address - Country:US
Practice Address - Phone:610-691-8401
Practice Address - Fax:610-691-0647
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist