Provider Demographics
NPI:1316823016
Name:COURTNEY, CANDICE MARIE
Entity type:Individual
Prefix:MS
First Name:CANDICE
Middle Name:MARIE
Last Name:COURTNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 3RD AVE N APT K2
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1473
Mailing Address - Country:US
Mailing Address - Phone:727-657-4037
Mailing Address - Fax:
Practice Address - Street 1:1050 3RD AVE N APT K2
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1473
Practice Address - Country:US
Practice Address - Phone:727-657-4037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician