Individual provider Active NPI

Candance Halona Hammonds, LCMHC

  • Mental Health Counselor
  • Fayetteville, NC
National Provider Identifier
1336212190
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5403 Issued in NC
Practice address
351 Wagoner Dr Ste 309
Fayetteville, NC 28303-4674
Phone
(910) 520-1899
NPI assigned
Nov 17, 2006
Last updated
Jun 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 5403 NC Primary
Professional Counselor 101YP2500X

Addresses

Primary practice location

351 Wagoner Dr Ste 309
Fayetteville, NC 28303-4674

Mailing address

1610 Pristine LN
Hope Mills, NC 28348-8066
Phone (910) 520-1899

Other identifiers 1

IdentifierTypeStateIssuer
6103328MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC, VA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20250324000207 NC Practitioner - Mental Health Counselor 7810419504 Reassigns benefits to 1 organization
I20250714002137 SC Practitioner - Mental Health Counselor 7810419504 Reassigns benefits to 1 organization
I20250714003620 VA Practitioner - Mental Health Counselor 7810419504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Talkspace Provider Network PAGroup PAC ID 5799136701, 249 clinicians

Practice addresses (Care Compare)

1111 Faison Ave
Fayetteville, NC 28304-5032
Phone (207) 487-5335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5403NCMDMental Health Counselor
9703SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Talkspace Provider Network PA CurrentSince Dec 1, 2024 Accepting new patients
Children's Home Society of NC Mental Health Past Accepting new patients

Locations

2578 Broadway
Ste 607
New York, NY 10025
Phone (304) 308-3735

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1336212190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 PRISTINE LN",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283488066",
            "telephone_number": "910-520-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 WAGONER DR STE 309",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034674",
            "telephone_number": "910-520-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMONDS",
        "first_name": "CANDANCE",
        "middle_name": "HALONA",
        "name_prefix": "Mrs.",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "5403",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103328",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.