Individual provider Active NPI

Candice Marie Tate, PH.D.

  • Clinical Psychologist
  • Morganton, NC
National Provider Identifier
1396912655
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5982 Issued in NC
Practice address
1000 S Sterling St
Morganton, NC 28655-3938
Phone
(828) 475-0085
NPI assigned
May 14, 2008
Last updated
Jun 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 5982 NC Primary

Addresses

Primary practice location

1000 S Sterling St
Morganton, NC 28655-3938

Mailing address

3518 Dogwood LN
Morganton, NC 28655-7150
Phone (303) 827-2123

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
I20220505002279 NC Practitioner - Clinical Psychologist 0749347813 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
5982NCMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Brian S Hissom and Associates PLLC CurrentSince Apr 1, 2022 Accepting new patients
Lifeworks Professional Corporation PastSince Nov 6, 2022 Accepting new patients

Locations

321 7th St NE
Ste B
Hickory, NC 28601
Phone (828) 485-2195

205 E Union St
Morganton, NC 28655
Phone (828) 403-0421

Interoperability endpoints

  • Direct secure messaging: candicetate@bsa.direct.kno2fy.com

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": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1396912655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3518 DOGWOOD LN",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286557150",
            "telephone_number": "303-827-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S STERLING ST",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286553938",
            "telephone_number": "828-475-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "CANDICE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "5982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morganton, NC

Sources for this page

Verify at the official NPI Registry.