Active NPI
Candace Danielle Clark, LPC
- Professional Counselor
- Loxley, AL
National Provider Identifier
1437775095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4279
- Practice address
- 26099 Highway 59
Suite a
Loxley, AL 36551 - Phone
- (251) 308-6160
- Fax
- (251) 262-6472
- NPI assigned
- Jun 19, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4279 | AL | Primary |
Addresses
Primary practice location
26099 Highway 59
Suite a
Loxley, AL 36551
Mailing address
26099 Highway 59
Suite a
Loxley, AL 36551
Phone (251) 308-6160
Other practice location 1
310 2nd St
Chickasaw, AL 36611-1532
Phone (205) 300-4770
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4279 | AL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Better Way Counseling LLC | Professional | Past | 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.
-
- Professional Counselor
- Loxley, AL
- NPI 1902555741
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672963200000",
"number": "1437775095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26099 HIGHWAY 59",
"address_2": "SUITE A",
"city": "LOXLEY",
"state": "AL",
"postal_code": "36551",
"telephone_number": "251-308-6160",
"fax_number": "251-262-6472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26099 HIGHWAY 59",
"address_2": "SUITE A",
"city": "LOXLEY",
"state": "AL",
"postal_code": "36551",
"telephone_number": "251-308-6160",
"fax_number": "251-262-6472"
}
],
"practiceLocations": [
{
"address_1": "310 2nd St",
"address_purpose": "LOCATION",
"city": "Chickasaw",
"state": "AL",
"postal_code": "366111532",
"country_code": "US",
"telephone_number": "205-300-4770",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLARK",
"first_name": "CANDACE",
"middle_name": "DANIELLE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-19",
"last_updated": "2023-01-06",
"certification_date": "2023-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AL",
"license": "4279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Loxley, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.