Candi L. Gadison, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

51009 Issued in TX

Practice address

3613 Williams Dr Ste 302
Georgetown, TX 78628-1369

Phone

(512) 966-1074

NPI assigned

Dec 13, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

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.

• Impact Counseling Services, Inc.

  • Mental Health Counselor
  • Georgetown, TX
  • NPI 1396312658
  Medicare reassignment Authorized official
• Kairos Counseling and Consultation, PLLC

  • Mental Health Counselor
  • Georgetown, TX
  • NPI 1801453840
  NPD Authorized official

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1265735302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 W CLARK ST",
            "city": "BARTLETT",
            "state": "TX",
            "postal_code": "765114076",
            "telephone_number": "129-661-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3613 WILLIAMS DR STE 302",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786281369",
            "telephone_number": "512-966-1074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "936 W Clark St",
            "address_purpose": "LOCATION",
            "city": "Bartlett",
            "state": "TX",
            "postal_code": "765114076",
            "country_code": "US",
            "telephone_number": "512-843-8432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GADISON",
        "first_name": "CANDI",
        "middle_name": "L.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-13",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "51009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "7372499272",
            "affiliation": "N",
            "endpointDescription": "fax",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "useOtherDescription": "secure information",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "936 W Clark St",
            "city": "Bartlett",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765114076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lucy Fuller, MA, CCC-SLP
• Jason Matthew Funke, DPT
• Rachelle Ann Gabaldon
• Alyssa Gabor
• Ethel G Gacasan, PT
• Michelle Marie Gaines, CRNA
• Cassandra Gallardo
• Aries Danielle Gallegos
• Jacqueline Galvani, M. ED., BCBA
• Rachel Lynne Gammon, DC

• Clinical Social Worker in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.