Individual provider Active NPI

Candace Leigh Farrell, LCSW

  • Clinical Social Worker
  • Springfield, PA
National Provider Identifier
1689711418
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW020724 Issued in PA
Practice address
1001 Baltimore Pike Ste 208
Springfield, PA 19064-2852
Phone
(215) 590-7555
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904006461 VA
Clinical Social Worker 1041C0700X CW020724 PA Primary

Addresses

Primary practice location

1001 Baltimore Pike Ste 208
Springfield, PA 19064-2852

Mailing address

1001 Baltimore Pike Ste 208
Springfield, PA 19064-2852
Phone (215) 590-7555

Other identifiers 1

IdentifierTypeStateIssuer
103777332MedicaidPA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW020724PAMDClinical Social Worker
0904006461VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindpath Care Centers, North Carolina, PLLC Clinical PastSince Aug 15, 2004 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1689711418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BALTIMORE PIKE STE 208",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642852",
            "telephone_number": "215-590-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BALTIMORE PIKE STE 208",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642852",
            "telephone_number": "215-590-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "CANDACE",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006461",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW020724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103777332",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; 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.