Candice A Blumhardt, LPCC

Individual provider Active NPI Professional Counselor · Fargo, ND

NPI 1700969227 · NPPES record last updated Feb 13, 2020

Key facts

NPI
1700969227
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LPCC 5158104158 (ND)
Practice address
1720 University Dr
Fargo, ND 58103-4904
Phone
(701) 234-7400
NPI assigned
Oct 21, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
LPCC 5158104158NDMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 515-8-1-04-158 ND
Professional Counselor 101YP2500X LPCC 5158104158 ND Yes

Addresses

Primary practice location

1720 University Dr
Fargo, ND 58103-4904

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other providers in Fargo, ND

All providers in Fargo, ND · Professional Counselor in North Dakota

Sources for this page

Verify at the official NPI Registry.