Candace Devon Allen-Staten, PSY.D.
Individual provider Active NPI Clinical Psychologist · Stockbridge, GA
NPI 1285857789 · NPPES record last updated Feb 2, 2010
Key facts
- NPI
- 1285857789
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY003320 (GA)
- Practice address
- 110 Eagles Walk
Suite 100
Stockbridge, GA 30281-7204 - Phone
- (770) 507-6044
- NPI assigned
- Apr 11, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY003320 | GA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medlin Treatment Center Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY003320 | GA | Yes |
Addresses
Primary practice location
110 Eagles Walk
Suite 100
Stockbridge, GA 30281-7204
Mailing address
2550 Akers Mill Rd SE
Apt E 15
Atlanta, GA 30339-3207
Phone (937) 369-6423
Other providers in Stockbridge, GA
- Faiza Ali
- Faria Ali
- Alan Alig
- Aligned Chiropractic & Wellness LLC
- All Clinical Labs Phase 1 Inc
- Chena Yvonne Allen
- Keosha Allen
- Leona Danielle Allen
- Marcus Dwayne Allen
- Michaela Alexus Allen
All providers in Stockbridge, GA · Clinical Psychologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.