Individual provider Active NPI

Candis Sherell Danzy

  • Clinical Social Worker
  • Wilson, NC
National Provider Identifier
1588823967
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P018015 Issued in NC
Practice address
2693 Forest Hills Rd SW
Wilson, NC 27893-8611
Phone
(252) 234-7800
Fax
(704) 982-5279
NPI assigned
Jun 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X P018015 NC Primary

Addresses

Primary practice location

2693 Forest Hills Rd SW
Wilson, NC 27893-8611

Mailing address

PO Box 180
Black Creek, NC 27813-0180

Other practice location 1

2115 Forest Hills Rd W Ste A
Wilson, NC 27893-3483
Phone (252) 237-1037

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
P018015NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1588823967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 180",
            "city": "BLACK CREEK",
            "state": "NC",
            "postal_code": "278130180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2693 FOREST HILLS RD SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278938611",
            "telephone_number": "252-234-7800",
            "fax_number": "704-982-5279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2115 Forest Hills Rd W Ste A",
            "address_purpose": "LOCATION",
            "city": "Wilson",
            "state": "NC",
            "postal_code": "278933483",
            "country_code": "US",
            "telephone_number": "252-237-1037",
            "fax_number": "252-237-2190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANZY",
        "first_name": "CANDIS",
        "middle_name": "SHERELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P018015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.