Candace Bullard Nelson, M.S.

Key facts

NPI

1427362276

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

Practice address

220 Magnolia Ave
Evergreen, AL 36401-3156

Phone

(251) 578-4545

NPI assigned

Aug 4, 2010

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• Southwest Alabama Behavioral Health Care Systems Mental Health Clinic/Center (Including Community Mental Health Center) · Monroeville, AL · NPI 1881628162
  NPD (past)
• Southwest Alabama Mental Health Community/Behavioral Health Agency · Evergreen, AL · NPI 1558674564
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Master of Science

Practice roles

Specialties & licenses

Addresses

Other names

• Ms. Candace Yvonne Bullard Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 4, 2010.

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1427362276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 MAGNOLIA AVE",
            "city": "EVERGREEN",
            "state": "AL",
            "postal_code": "364013156",
            "telephone_number": "251-578-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 MAGNOLIA AVE",
            "city": "EVERGREEN",
            "state": "AL",
            "postal_code": "364013156",
            "telephone_number": "251-578-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CANDACE",
        "middle_name": "BULLARD",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-04",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDACE",
            "last_name": "BULLARD",
            "middle_name": "YVONNE",
            "prefix": "MS.",
            "credential": "M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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All providers in Evergreen, AL · Mental Health Counselor in Alabama