Candice Mitchell, MS,LGPC,NCC

Individual provider Active NPI Professional Counselor · Marriottsville, MD

NPI 1760066062 · NPPES record last updated Jun 23, 2021

Key facts

NPI
1760066062
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LGP11470 (MD)
Practice address
11155 Stratfield CT
Marriottsville, MD 21104-1650
Phone
(443) 219-5412
NPI assigned
May 12, 2021
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LGP11470MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fundamental Solutions Psychotherapy. LLC Current
since May 8, 2022
Accepting new patients

Locations

11155 Stratfield Ct
Marriottsville, MD 21104
Phone (410) 487-9477

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LGP11470 MD
Professional Counselor 101YP2500X LGP11470 MD Yes

Addresses

Primary practice location

11155 Stratfield CT
Marriottsville, MD 21104-1650

Mailing address

11155 Stratfield CT # 21104
Marriottsville, MD 21104-1650
Phone (443) 934-1462

Other names

  • Candice Mitchell Ferinde Professional name

Other providers in Marriottsville, MD

All providers in Marriottsville, MD · Professional Counselor in Maryland

Sources for this page

Verify at the official NPI Registry.