Candace Kotkin-Decarvalho, LCADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

37LC00318700 Issued in NJ

Practice address

3 Corbett Way
Eatontown, NJ 07724-2283

Phone

(732) 210-0509

Fax

(732) 542-1948

NPI assigned

Sep 22, 2020

Last updated

Sep 22, 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1740896042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CORBETT WAY",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077242283",
            "telephone_number": "732-210-0509",
            "fax_number": "732-542-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CORBETT WAY",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077242283",
            "telephone_number": "732-210-0509",
            "fax_number": "732-542-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTKIN-DECARVALHO",
        "first_name": "CANDACE",
        "credential": "LCADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00318700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Kodopidis
• Anna Katherine Koenigsdorf, FNP
• Heather Koenigsfest, MA, LPC
• Paul A Kolarsick, M.D.
• Charles H Koo, M.D.
• Christopher Kotwicki, DC
• Patti Kousoulis
• Jordan L Kovacs, DC
• Kerry L. Krachman
• Amanda Marie Kramer, DO

• Addiction (Substance Use Disorder) Counselor in Eatontown, NJ
• Providers in Eatontown, NJ by specialty
• Addiction (Substance Use Disorder) Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.