Ebbesen, Candice Claire

Ebbesen, Candice Claire is an sole proprietor health care provider with primary practice located at 104 Wayne St , Jersey City NJ 07302-5573. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Ebbesen, Candice Claire can be contacted via phone (201) 780-0905.

Contact Information

Primary practice address
104 Wayne St Jersey City NJ 07302-5573
Phone: (201) 780-0905
Fax: (973) 673-5782
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 37F100175300 New Jersey

Profile Details

NPI number 1013352012
LBN Legal business name Ebbesen, Candice Claire
Credentials MA, EDS MFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 3rd, 2013
Last updated Oct 7th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013352012 NPPES
New Jersey MEDICAID 216352

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