Provider Demographics
NPI:1124782800
Name:ASTON, CANDICE N (PHD)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:N
Last Name:ASTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1229
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-1229
Mailing Address - Country:US
Mailing Address - Phone:410-356-9208
Mailing Address - Fax:443-200-0267
Practice Address - Street 1:1311 LONDONTOWN BLVD STE 130A
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6439
Practice Address - Country:US
Practice Address - Phone:410-356-9208
Practice Address - Fax:443-200-0267
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06735103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling