Candice Clark, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P010180 Issued in NC

Practice address

405 Biggs St
Laurinburg, NC 28352-4109

Phone

(191) 061-0444

Fax

(910) 610-4434

NPI assigned

Nov 9, 2015

Last updated

Nov 9, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advantage Behavioral Healthcare Inc.

  • Mental Health Counselor
  • Whiteville, NC
  • NPI 1689750663
  Medicare reassignment NPD
• Advantage Behavioral Healthcare Inc.

  • Mental Health Counselor
  • Whiteville, NC
  • NPI 1902100019

  Clinical

  NPD (past)

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

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1528431814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 BIGGS ST",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283524109",
            "telephone_number": "191-061-0444",
            "fax_number": "910-610-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 BIGGS ST",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283524109",
            "telephone_number": "191-061-0444",
            "fax_number": "910-610-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CANDICE",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-09",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P010180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian Faith Home Care Agency
• Marc Christiansen, MARC CHRISTIANSEN
• Naomi Chun, OD
• Carla Clark-McRae, LCSW
• Adam D Clark, PAC
• Kristy Clark
• Sheila Green Clark, CFM
• Hope McKee Cole, PA-C
• Community Innovations
• Community Innovations

• Clinical Social Worker in Laurinburg, NC
• Providers in Laurinburg, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.