Individual provider Active NPI

Candace Rajonda Ducking Etienne

  • Counselor
  • Winter Haven, FL
National Provider Identifier
1437812013
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
1203795 Issued in FL
Practice address
308 Avenue K SE
Winter Haven, FL 33880-4147
Phone
(863) 458-5456
NPI assigned
Oct 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X
Counselor 101Y00000X 1203795 FL Primary
Developmentally Disabled Services Day Training Agency 251C00000X FL
Non-emergency Medical Transport (VAN) 343900000X
Adult Companion 372600000X

Addresses

Primary practice location

308 Avenue K SE
Winter Haven, FL 33880-4147

Mailing address

308 Avenue K SE
Winter Haven, FL 33880-4147
Phone (863) 207-5191

Other identifiers 1

IdentifierTypeStateIssuer
109520700MedicaidFL

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

LicenseStateTypeSpecialty
1203795FLMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
365 Neighbors Care Inc Day Training, Developmentally Disabled Services Current Accepting new patients
TLC Comfort Care Industries Inc Day Training, Developmentally Disabled Services Current Accepting new patients

Locations

308 Avenue K SE
Winter Haven, FL 33880
Phone (863) 229-5353

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.

NPI Registry JSON

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1437812013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 AVENUE K SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804147",
            "telephone_number": "863-207-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 AVENUE K SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804147",
            "telephone_number": "863-458-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKING ETIENNE",
        "first_name": "CANDACE",
        "middle_name": "RAJONDA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-20",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "1203795",
            "primary": true
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109520700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.