Provider Demographics
NPI:1306186879
Name:LAIR, CANDACE (NCC, LPC)
Entity type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:
Last Name:LAIR
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9318 HIGHWAY 959
Mailing Address - Street 2:
Mailing Address - City:SLAUGHTER
Mailing Address - State:LA
Mailing Address - Zip Code:70777-4225
Mailing Address - Country:US
Mailing Address - Phone:225-235-6008
Mailing Address - Fax:
Practice Address - Street 1:9318 HIGHWAY 959
Practice Address - Street 2:
Practice Address - City:SLAUGHTER
Practice Address - State:LA
Practice Address - Zip Code:70777-4225
Practice Address - Country:US
Practice Address - Phone:225-235-6008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4594101YP2500X
LAAN472743101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool