Individual provider Active NPI

Candace Marie Scirrotto, MA, LPCA

  • Professional Counselor
  • Wilmington, NC
National Provider Identifier
1376017616
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
A14182 Issued in NC
Practice address
615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone
(910) 343-0145
Fax
(910) 202-9966
NPI assigned
Jan 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X A14182 NC Primary

Addresses

Primary practice location

615 Shipyard Blvd
Wilmington, NC 28412-6431

Mailing address

615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 343-0145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240509004036 NC Practitioner - Mental Health Counselor 9436590296 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Ties of Brunswick, LLCGroup PAC ID 7911309430, 8 clinicians

Practice addresses (Care Compare)

720 N 3Rd St
Suite 401
Wilmington, NC 28401-3474
Phone (910) 769-9126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
A14182NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Horizons Center, Inc. Current Accepting new patients
Coastal Horizons Center, Inc CurrentSince Dec 5, 2023 Accepting new patients
Coastal Horizons Center, Inc. Current Accepting new patients
Family Ties of Brunswick, LLC Professional CurrentSince Jul 1, 2025 Accepting new patients
Coastal Horizons Center Inc CurrentSince Dec 5, 2023 Accepting new patients

Locations

309 Progress Dr
Burgaw, NC 28425
Phone (910) 259-0445

5320 Bridgers Rd
Ste 4
Shallotte, NC 28470
Phone (910) 754-4097

120 Coastal Horizons Dr
Shallotte, NC 28470
Phone (910) 754-4515

615 Shipyard Blvd
Wilmington, NC 28412
Phone (910) 202-5709

720 N 3rd St
Ste 401
Wilmington, NC 28401
Phone (910) 769-9126

Organizations & group practices 5

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": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1376017616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-343-0145",
            "fax_number": "910-202-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-343-0145",
            "fax_number": "910-202-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIRROTTO",
        "first_name": "CANDACE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "MA, LPCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-21",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A14182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.