Candice Lynn Wilson, M.S. CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

003725 Issued in CT

Practice address

97 Preston Rd
Griswold, CT 06351-2516

Phone

(860) 376-4438

NPI assigned

May 21, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326257189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 NICHOLS LN",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063853611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 PRESTON RD",
            "city": "GRISWOLD",
            "state": "CT",
            "postal_code": "063512516",
            "telephone_number": "860-376-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CANDICE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "003725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Town of Griswold Board of Education
• Brittany Van Steeden
• Cara Vaslet, BS, LCDP, LCDC III
• Mildred Wessner, LMSW
• Heidi Marie Willard
• Heather Yanovitch

• Speech-Language Pathologist in Griswold, CT
• Providers in Griswold, CT by specialty
• Speech-Language Pathologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.