Provider Demographics
NPI:1902175201
Name:HOLLIDAY, CANDICE JEANETTE (LPC)
Entity Type:Individual
Prefix:MS
First Name:CANDICE
Middle Name:JEANETTE
Last Name:HOLLIDAY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 PAWTUCKET CT
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-5048
Mailing Address - Country:US
Mailing Address - Phone:512-413-7471
Mailing Address - Fax:512-233-5168
Practice Address - Street 1:821 GRAND AVE PARKWAY
Practice Address - Street 2:
Practice Address - City:PLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2197
Practice Address - Country:US
Practice Address - Phone:512-413-7471
Practice Address - Fax:512-233-5168
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62428101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional