Candice Lynn Carr-Callen, AGENCY AFFILIATED

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CG60606578 Issued in WA

Practice address

812 S Walnut St
Spokane, WA 99204-3326

Phone

(509) 624-3251

NPI assigned

Feb 5, 2019

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Spokane Addiction Recovery Centers

  • Substance Abuse Rehabilitation Facility
  • Spokane, WA
  • NPI 1013030147
  NPD (past)
• Spokane Addiction Recovery Centers

  dba Sparc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Spokane, WA
  • NPI 1598109407
  NPD (past)

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1629533559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 S WALNUT ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992043326",
            "telephone_number": "509-624-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 S WALNUT ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992043326",
            "telephone_number": "509-624-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR-CALLEN",
        "first_name": "CANDICE",
        "middle_name": "LYNN",
        "credential": "AGENCY AFFILIATED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG60606578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Carpenter, C.N.M.
• Jennifer Ann Carpenter
• Khloe Nadine Carpenter
• Sierra Lynne Carpenter
• Richard Donald Carper, PHARM.D.
• Janessa Carr
• Oliver William Carr, DMD
• Rhonda M Carr, RN
• Stephen Michael Carr
• Brina Shaw Carrigan, MSW, LICSW, LCSW

• Mental Health Counselor in Spokane, WA
• Providers in Spokane, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; 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.