Candace Bynum-Omodunni

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

APC003982 Issued in GA

Practice address

1394 Laney Walker Blvd
Augusta, GA 30901-2763

Phone

(706) 737-1119

Fax

(706) 737-1127

NPI assigned

Oct 11, 2013

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: candace.bynum-omodunni.1@23300.direct.athenahealth.com

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.

• Ga Excel Behavioral Health Services

  • Community/Behavioral Health Agency
  • Decatur, GA
  • NPI 1982216438
  NPD
• Preferred Choice

  • Case Management Agency
  • Augusta, GA
  • NPI 1154668416
  NPD (past)

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

{
    "created_epoch": "1381449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1528495330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1394 LANEY WALKER BLVD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1394 LANEY WALKER BLVD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012763",
            "telephone_number": "706-737-1119",
            "fax_number": "706-737-1127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1345 Redmond Cir NW",
            "address_purpose": "LOCATION",
            "city": "Rome",
            "state": "GA",
            "postal_code": "301651307",
            "country_code": "US",
            "telephone_number": "910-742-9243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BYNUM-OMODUNNI",
        "first_name": "CANDACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-11",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "APC003982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Butler
• April Maxwell Butzon, LMSW
• Brooke Buxton
• William Pershing Byars Jr., M.D.
• Donna Jean Byers
• Heather Scott Byrd, M.D.
• James Kenneth Byrd, M.D.
• Lelan Clinton Byrd, M.D.
• Sean Michael-Peter Byrne, DO
• C & C MD PC

• Mental Health Counselor in Augusta, GA
• Providers in Augusta, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.