Candace Rae Jeffries Nichols, MS LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4595 Issued in OK

Practice address

1108 N Wheeler Ave
Sallisaw, OK 74955-2227

Phone

(918) 775-5513

NPI assigned

Oct 5, 2007

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

Other names 1

• Candace Rae Jeffries Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

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.

• Creoks Mental Health Services

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1710583372
  NPD (past)

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1568650463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 N WHEELER AVE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "74955",
            "telephone_number": "918-775-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 N WHEELER AVE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749552227",
            "telephone_number": "918-775-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "CANDACE",
        "middle_name": "RAE JEFFRIES",
        "credential": "MS LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-05",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "4595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDACE",
            "last_name": "JEFFRIES",
            "middle_name": "RAE",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Sallisaw, OK
• Providers in Sallisaw, OK by specialty
• Professional Counselor in Oklahoma

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.