Candace Charley Clyburn-Gamble, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

19193 Issued in NC

Practice address

8853 Festival Way
Charlotte, NC 28215-3285

Phone

(770) 315-0913

NPI assigned

Sep 11, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Candance Charley Clyburn Former name

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Monarch

  • Community/Behavioral Health Agency
  • Albemarle, NC
  • NPI 1801116405
  Medicare reassignment NPD
• Empowerment Quality Care Services, LLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1437384302
  NPD
• Monarch

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1073267126
  NPD
• Monarch

  • Community/Behavioral Health Agency
  • Albemarle, NC
  • NPI 1972644334
  NPD

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1225815517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8853 FESTIVAL WAY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282153285",
            "telephone_number": "770-315-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8853 FESTIVAL WAY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282153285",
            "telephone_number": "770-315-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYBURN-GAMBLE",
        "first_name": "CANDACE",
        "middle_name": "CHARLEY",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "19193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDANCE",
            "last_name": "CLYBURN",
            "middle_name": "CHARLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• CLT Custom Cranial Prosthesis
• Cltspeech
• Club Success
• Chrystell Laura Cluck, PA-C
• Molly Kasson Clune
• Kanitra Shavon Clyburn, NP
• Telisha S Clyburn
• Brittany Bergin Clyne, MD
• Stephen B Clyne, M.D.
• CM Counseling, PLLC

• Mental Health Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.