Individual provider Active NPI

Candace Marie Drake Cardin, PSY.D.

  • Clinical Psychologist
  • Pensacola, FL
National Provider Identifier
1063724078
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1760 Issued in AL
Practice address
790 Veterans Way
Pensacola, FL 32507-1000
Phone
(850) 912-2296
Fax
(850) 912-2296
NPI assigned
Jul 7, 2010
Last updated
Dec 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1760 AL Primary

Addresses

Primary practice location

790 Veterans Way
Pensacola, FL 32507-1000

Mailing address

790 Veterans Way
Pensacola, FL 32507-1000
Phone (850) 912-2296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5940NCMDGeneral Practice Dentistry
1760ALMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Candace Cardin Counseling PLLC Current Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1063724078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 VETERANS WAY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325071000",
            "telephone_number": "850-912-2296",
            "fax_number": "850-912-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 VETERANS WAY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325071000",
            "telephone_number": "850-912-2296",
            "fax_number": "850-912-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE CARDIN",
        "first_name": "CANDACE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-07",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "1760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.