Candace Kay Childers, MA

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

License

1477 Issued in NC

Practice address

145 W Parker Rd Ste a
Morganton, NC 28655-4649

Phone

(828) 433-5177

Fax

(828) 433-1127

NPI assigned

Mar 14, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• NC DHHS Child and Family Well-Being

  • Early Intervention Provider Agency
  • Morganton, NC
  • NPI 1114143542
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1013040104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 W PARKER RD STE A",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286554649",
            "telephone_number": "828-433-5177",
            "fax_number": "828-433-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 W PARKER RD STE A",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286554649",
            "telephone_number": "828-433-5177",
            "fax_number": "828-433-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "CANDACE",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NC",
            "license": "1477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "046N2",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tricia W Chapman, LPCA
• Eric Hong-Wen Chen, MD
• Chesterfield Adult Care Home Inc.
• Chesterfield Adult Care LLC
• Chesterfield Family Care Home, LLC.
• James Michael Chimiak, M.D.
• Christopher John Chiota, R.PH.
• Mythri Chittilla
• Hae Jin Chung, M.D.
• Janice Church, M.A.

• Intellectual & Developmental Disabilities Psychologist in Morganton, NC
• Providers in Morganton, NC by specialty
• Intellectual & Developmental Disabilities Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.