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CANDICE R PICARD LAC

Addiction Substance Use Disorder

Minot, North Dakota

Provider NPI: 1255360616

Provider Information:
 CANDICE R PICARD LAC
Gender: F
Not Sole Proprietor

Practice Location:
1015 S BROADWAY STE 18  MINOT, ND 58701 US
Tel: 701-857-8500  Fax: 701-857-8555

Business Mailing Address:
1015 S BROADWAY STE 18  MINOT, ND 58701 US
Tel: 701-857-8500  Fax: 701-857-8555

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
ND1416

Other Provider Identifiers:

IssuerNumberStateType
054517ND05
BCBS ND PIN014525ND01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







ADDICTION JOBS ND - Page 1



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