Active NPI
Demetria Candler, LSW
- Counselor
- Champaign, IL
National Provider Identifier
1730804113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 150108025
- Practice address
- 411 Devonshire Dr
Champaign, IL 61820-7286 - Phone
- (217) 904-3035
- NPI assigned
- Oct 7, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 150108025 | IL | Primary |
Addresses
Primary practice location
411 Devonshire Dr
Champaign, IL 61820-7286
Mailing address
411 Devonshire Dr
Champaign, IL 61820-7286
Phone (217) 904-3035
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
| License | State | Type | Specialty |
|---|---|---|---|
| 150108025 | IL | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kendrick Counseling, PLLC | Past | Accepting new patients | |
| Symatree LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Marriage & Family Therapist
- Champaign, IL
- NPI 1225612872
-
- Psychiatric/Mental Health Nurse Practitioner
- Champaign, IL
- NPI 1790496099
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665100800000",
"number": "1730804113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 DEVONSHIRE DR",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618207286",
"telephone_number": "217-904-3035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 DEVONSHIRE DR",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618207286",
"telephone_number": "217-904-3035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANDLER",
"first_name": "DEMETRIA",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-07",
"last_updated": "2022-10-07",
"certification_date": "2022-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "150108025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.