Candice Jarvis, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R055452-1 Issued in NY

Practice address

615 Broadway Apt 31
Amityville, NY 11701-2140

Phone

(631) 532-5453

NPI assigned

Apr 27, 2015

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

Medicare fee-for-service enrollment

Enrolled in NY

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

Clinical Social Worker

Education

Other, 1996

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.

• Chatandchange Counseling Services

  • Community/Behavioral Health Agency
  • Massapequa, NY
  • NPI 1134576697
  NPD Authorized official

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1275910457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 BROADWAY APT 31",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012140",
            "telephone_number": "631-532-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 BROADWAY APT 31",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012140",
            "telephone_number": "631-532-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARVIS",
        "first_name": "CANDICE",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-27",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R055452-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lana James
• Sharrell M James, LPN
• Kimberely Jamison
• Daniel Ruben Jara Palomino, LMSW
• Stacy-Ann Gerdine Jarrett, FNP
• Susan Jayson, LCSW
• Gesael Jean Charles, RN
• Joseph Case Jean Charles, PMHNP
• Tina Jean
• Jeffrey Edward Poplarski DC LLC

• Clinical Social Worker in Amityville, NY
• Providers in Amityville, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; 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.