Provider Demographics
NPI:1902679814
Name:COUGHENOUR, CANDICE (LMFT)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:COUGHENOUR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1654 ELLSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:CARNEGIE
Mailing Address - State:PA
Mailing Address - Zip Code:15106-3909
Mailing Address - Country:US
Mailing Address - Phone:412-719-4533
Mailing Address - Fax:
Practice Address - Street 1:4 SMITHFIELD ST STE 520
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-2226
Practice Address - Country:US
Practice Address - Phone:412-354-0636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF001549106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist