Active NPI
Linda Candlish, MS
- Psychologist
- Bloomsburg, PA
National Provider Identifier
1205917093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS004657L
- Practice address
- 730 E 2ND St
Bloomsburg, PA 17815-2009 - Phone
- (570) 389-0547
- Fax
- (570) 389-0547
- NPI assigned
- Oct 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS004657L | PA | Primary |
Addresses
Primary practice location
730 E 2ND St
Bloomsburg, PA 17815-2009
Mailing address
730 E 2ND St
Bloomsburg, PA 17815-2009
Phone (570) 389-0547
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1017359600004 | Medicaid | PA |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS004657L | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320192000000",
"number": "1205917093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 E 2ND ST",
"city": "BLOOMSBURG",
"state": "PA",
"postal_code": "178152009",
"telephone_number": "570-389-0547",
"fax_number": "570-389-0547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 E 2ND ST",
"city": "BLOOMSBURG",
"state": "PA",
"postal_code": "178152009",
"telephone_number": "570-389-0547",
"fax_number": "570-389-0547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANDLISH",
"first_name": "LINDA",
"name_prefix": "Ms.",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-18",
"last_updated": "2011-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS004657L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1017359600004",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.