Candice Smith, LCSW
Individual provider Active NPI Clinical Social Worker · Tchula, MS
NPI 1487835567 · NPPES record last updated Jan 3, 2014
Key facts
- NPI
- 1487835567
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C7516 (MS)
- Practice address
- 16067 M. L. K. Dr.
Tchula, MS 39169-0518 - Phone
- (662) 299-3264
- NPI assigned
- Nov 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C7516 | MS | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C7516 | MS | Yes |
Addresses
Primary practice location
16067 M. L. K. Dr.
Tchula, MS 39169-0518
Mailing address
PO Box 518
Tchula, MS 39169-0518
Phone (662) 299-3264
Other providers in Tchula, MS
- Heaven Sent Foot Healthcare, PLCC
- Nikita Hogan
- Mallory Community Health
- Glenn Daniel Roberts
- Thomas Ross
- The Myers Foundation Christian Family Health Centers
- Thomas Ross
- Dealice Nikita Young
All providers in Tchula, MS · Clinical Social Worker in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.