Individual provider Active NPI

Candace Runaas, LMFT SUPERVISOR

  • Marriage & Family Therapist
  • Houston, TX
National Provider Identifier
1356904973
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
203065 Issued in TX
Practice address
15555 Kuykendahl Rd Ste 318a
Houston, TX 77090-3651
Phone
(832) 224-3436
NPI assigned
Apr 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 203065 TX Primary

Addresses

Primary practice location

15555 Kuykendahl Rd Ste 318a
Houston, TX 77090-3651

Mailing address

15555 Kuykendahl Rd Ste 318a
Houston, TX 77090-3651
Phone (832) 224-3436

Other practice location 1

6823 Cypresswood Dr
Spring, TX 77379-7705
Phone (281) 376-8006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
203065TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Interface-Samaritan Counseling Centers PastSince Nov 8, 2012 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1356904973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15555 KUYKENDAHL RD STE 318A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903651",
            "telephone_number": "832-224-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15555 KUYKENDAHL RD STE 318A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903651",
            "telephone_number": "832-224-3436"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6823 Cypresswood Dr",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773797705",
            "country_code": "US",
            "telephone_number": "281-376-8006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUNAAS",
        "first_name": "CANDACE",
        "credential": "LMFT SUPERVISOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "203065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.