Candace L. Gillespie, ED. D., NCC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1074 Issued in MS

Practice address

829 W South St
Mound Bayou, MS 38762-9797

Phone

(662) 588-2481

NPI assigned

Aug 13, 2020

Last updated

Aug 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, ID, NJ3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regional Womens Health Group LLCGroup PAC ID 2961316328, 352 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Regional Women's Health Group, LLC

  dba Axia Women's Health

  • Obstetrics & Gynecology Physician
  • Voorhees, NJ
  • NPI 1548215536
  Medicare reassignment Care Compare group
• MCCD FL Psychiatry Services PA

  dba Talkiatry

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1659003457

  MS

  Medicare reassignment NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  ID, MS, Professional

  Medicare reassignment NPD
• New Horizons Wellness, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mound Bayou, MS
  • NPI 1962085563
  NPD Authorized official

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1710598586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 W SOUTH ST",
            "city": "MOUND BAYOU",
            "state": "MS",
            "postal_code": "387629797",
            "telephone_number": "662-588-2481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 W SOUTH ST",
            "city": "MOUND BAYOU",
            "state": "MS",
            "postal_code": "387629797",
            "telephone_number": "662-588-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "CANDACE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "ED. D., NCC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": "6979",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1074",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "MS",
            "license": "173503",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delta Health Center, Inc.
• Delta Health Center, Inc. (Delta Health Center Mobile Health Unit #1)
• Carolyn Eubanks, DMD
• Inge B Ford, DMD
• Rotonia Gates, LPN
• Laura Grant
• Shaunde Gray, MHA, COTA, LIA
• Home of Care Personal Care Services
• Beverly C Johnson, MSW
• Carol Mack, LCSW

• Professional Counselor in Mound Bayou, MS
• Providers in Mound Bayou, MS by specialty
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.