Candice Rachel Smith, LPCA

Primary specialty

CounselorTaxonomy code 101Y00000X

License

A12107 Issued in NC

Practice address

8512 Six Forks Rd Ste 101
Raleigh, NC 27615-3256

Phone

(919) 464-7398

NPI assigned

Apr 5, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Candice Rachel Tynes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1285097345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8316 AMBER LANTERN ST",
            "address_2": "APARTMENT 207",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276134582",
            "telephone_number": "919-464-7398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8512 SIX FORKS RD STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153256",
            "telephone_number": "919-464-7398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CANDICE",
        "middle_name": "RACHEL",
        "name_prefix": "Mrs.",
        "credential": "LPCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-05",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "A12107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA BOARD OF LICENSED PROFESSIONAL COUNSELORS",
            "identifier": "A12107",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDICE",
            "last_name": "TYNES",
            "middle_name": "RACHEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brian Richard Smith, PT
• Brittani Smith, LCSWA
• Brittany Crystal Smith
• Bryan Doreko Paul Smith, QP, ITFS, MHFA
• Cameron Elizabeth Smith
• Carl Lynwood Smith, M.D.
• Cassandra M Smith, LPCA
• Cayce Watts Smith, PA-C
• Christen Elizabeth Smith, LCMHC
• Clare Smith

• Counselor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.