Organization Active NPI

Candace V. Love., PHD, PC

  • Clinical Psychologist
  • Glenwood Springs, CO
National Provider Identifier
1073658647
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
CANDACE V. LOVE., PHD, PC
Practice address
4263 Clark St
Glenwood Springs, CO 81601-4591
Phone
(847) 767-3540
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Authorized official

Name
Dr. Candace Vivian Love, PHDNPI 1972657724
Title
President
Phone
(847) 767-3540

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

4263 Clark St
Glenwood Springs, CO 81601-4591

Mailing address

4263 Clark St
Glenwood Springs, CO 81601-4591
Phone (847) 767-3540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230923000685 CO Part B Supplier - Clinic/Group Practice 2860598869 Receives reassigned benefits from 1 practitioner
Practice locations: Glenwood Springs, CO

National Provider Directory

National Provider Directory

Locations

556 W Webster Ave
Chicago, IL 60614
Phone (773) 883-2000

625 N Michigan Ave
Ste 171
Chicago, IL 60611

230 E Ohio St
Ste 405
Chicago, IL 60611
Phone (312) 482-9262

419 Center St
Ste C
Grayslake, IL 60030
Phone (262) 412-7302

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695340800000",
    "number": "1073658647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4263 CLARK ST",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014591",
            "telephone_number": "847-767-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4263 CLARK ST",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014591",
            "telephone_number": "847-767-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANDACE V. LOVE., PHD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A",
        "authorized_official_last_name": "LOVE",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_middle_name": "VIVIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-767-3540",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.