Provider Demographics
NPI:1548335193
Name:LEININGER, CANDISE WELLS (LPC)
Entity type:Individual
Prefix:MS
First Name:CANDISE
Middle Name:WELLS
Last Name:LEININGER
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:PO BOX 20694
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003
Mailing Address - Country:US
Mailing Address - Phone:307-274-8717
Mailing Address - Fax:307-637-2899
Practice Address - Street 1:2622 PIONEER AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3024
Practice Address - Country:US
Practice Address - Phone:307-274-8717
Practice Address - Fax:307-637-2899
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2017-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY946101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor