Individual provider Active NPI

Candace Kieffer

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1174115695
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
011708 Issued in NY
Practice address
80 5TH Ave RM 903
New York, NY 10011-7611
Phone
(844) 866-8336
NPI assigned
Feb 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 011708 NY Primary

Addresses

Primary practice location

80 5TH Ave RM 903
New York, NY 10011-7611

Mailing address

908 South Ave
Horseheads, NY 14845-2635
Phone (076) 425-9561

Other practice location 1

908 South Ave
Horseheads, NY 14845-2635
Phone (607) 425-9561

Other names 1

  • Candace Todd Former name

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

LicenseStateTypeSpecialty
011708NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Services of Chemung County, Inc. PastSince Feb 1, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1174115695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 SOUTH AVE",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148452635",
            "telephone_number": "076-425-9561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 5TH AVE RM 903",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117611",
            "telephone_number": "844-866-8336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "908 South Ave",
            "address_purpose": "LOCATION",
            "city": "Horseheads",
            "state": "NY",
            "postal_code": "148452635",
            "country_code": "US",
            "telephone_number": "607-425-9561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIEFFER",
        "first_name": "CANDACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "011708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDACE",
            "last_name": "TODD",
            "credential": "MHC-LP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.