Active NPI
Candrick C. Darkashade
- Student in an Organized Health Care Education/Training Program
- Newark, NJ
National Provider Identifier
1225553084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 285 Roseville Ave
Newark, NJ 07107-1703 - Phone
- (973) 481-2200
- NPI assigned
- Aug 13, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
285 Roseville Ave
Newark, NJ 07107-1703
Mailing address
610 Forest View Drive
Avenel, NJ 07001
Phone (848) 467-1409
Other practice location 1
50 Norfolk St
Newark, NJ 07103-3228
Phone (973) 623-3386
Other practice location 2
1958 Westfield Ave
Scotch Plains, NJ 07076-1764
Phone (908) 405-5802
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 173-040 | NJ | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American International Clinical Enterprise | Multi-Specialty | Past | 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.
-
- Addiction (Substance Use Disorder) Psychologist
- Newark, NJ
- NPI 1912424805
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786579200000",
"number": "1225553084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 FOREST VIEW DRIVE",
"city": "AVENEL",
"state": "NJ",
"postal_code": "07001",
"telephone_number": "848-467-1409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "285 ROSEVILLE AVE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071071703",
"telephone_number": "973-481-2200"
}
],
"practiceLocations": [
{
"address_1": "50 Norfolk St",
"address_purpose": "LOCATION",
"city": "Newark",
"state": "NJ",
"postal_code": "071033228",
"country_code": "US",
"telephone_number": "973-623-3386",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1958 Westfield Ave",
"address_purpose": "LOCATION",
"city": "Scotch Plains",
"state": "NJ",
"postal_code": "070761764",
"country_code": "US",
"telephone_number": "908-405-5802",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DARKASHADE",
"first_name": "CANDRICK",
"middle_name": "C.",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-08-13",
"last_updated": "2026-08-13",
"certification_date": "2026-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.