Active NPI
Candace Penn, LPC
- Professional Counselor
- Andalusia, AL
National Provider Identifier
1003317264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3599
- Practice address
- 19815 Bay Branch Rd
Andalusia, AL 36420-9234 - Phone
- (334) 488-0153
- NPI assigned
- Feb 23, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3599 | AL | Primary |
Addresses
Primary practice location
19815 Bay Branch Rd
Andalusia, AL 36420-9234
Mailing address
1279 Elm Street Rd
Troy, AL 36081-4664
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3599 | AL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519344000000",
"number": "1003317264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1279 ELM STREET RD",
"city": "TROY",
"state": "AL",
"postal_code": "360814664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19815 BAY BRANCH RD",
"city": "ANDALUSIA",
"state": "AL",
"postal_code": "364209234",
"telephone_number": "334-488-0153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENN",
"first_name": "CANDACE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-23",
"last_updated": "2018-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AL",
"license": "3599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Andalusia, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.