Individual provider Active NPI

Dawn McCandless, MSW, LCSW

  • Clinical Social Worker
  • Goshen, IN
National Provider Identifier
1659796829
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34000888A Issued in IN
Practice address
58512 Old County Road 17
Goshen, IN 46528-8464
Phone
(574) 875-5622
NPI assigned
Feb 25, 2014
Last updated
Feb 25, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34000888A IN Primary

Addresses

Primary practice location

58512 Old County Road 17
Goshen, IN 46528-8464

Mailing address

24401 Merrimac LN
Elkhart, IN 46517-3325
Phone (574) 238-7072

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
34000888AINMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1659796829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24401 MERRIMAC LN",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465173325",
            "telephone_number": "574-238-7072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58512 OLD COUNTY ROAD 17",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465288464",
            "telephone_number": "574-875-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCANDLESS",
        "first_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-25",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34000888A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; 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.