Candise Thomas

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CSAC 2256 Issued in NC

Practice address

2505 Court Dr
Gastonia, NC 28054-2140

Phone

(704) 842-6359

Fax

(704) 854-4860

NPI assigned

Mar 23, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1770945354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 COURT DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542140",
            "telephone_number": "704-842-6359",
            "fax_number": "704-854-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 COURT DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542140",
            "telephone_number": "704-842-6359",
            "fax_number": "704-854-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CANDISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "202493799",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "CSAC 2256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC SUBSTANCE ABUSE LICENSING BOARD",
            "identifier": "CSAC2256",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCSAPPB",
            "identifier": "2535",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Therapeutic Support Services
• Therapsych Behavioral Health & Wellness, PLLC
• Colleen Lyn Thibaut, D.O.
• Steven David Thies, M.D.
• Alea Marie Thomas
• Danielle Marie Ruth Thomas, MSW, LCSWA
• David Timothy Thomas, M.D.
• Kayla Lynn Thomas, MD
• Kenya Evette Thomas, FNP-C
• Klarice Thomas, MASSAGE THERAPIST

• Addiction (Substance Use Disorder) Counselor in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.