Provider Demographics
NPI:1730899923
Name:KANDICE FRICKE, PLLC
Entity type:Organization
Organization Name:KANDICE FRICKE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC-S/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KANDICE
Authorized Official - Middle Name:KIMBERLY
Authorized Official - Last Name:FRICKE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:361-844-8080
Mailing Address - Street 1:3833 S STAPLES ST STE N202
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5219
Mailing Address - Country:US
Mailing Address - Phone:361-844-8080
Mailing Address - Fax:
Practice Address - Street 1:3833 S STAPLES ST STE N202
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5219
Practice Address - Country:US
Practice Address - Phone:361-844-8080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty