Individual provider Active NPI

Kandace Paige Demers, LCSW

  • Clinical Social Worker
  • Lowell, MA
National Provider Identifier
1790503753
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW231035 Issued in MA
Practice address
126 Phoenix Ave
Lowell, MA 01852-4991
Phone
(978) 863-8867
NPI assigned
Sep 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW231035 MA Primary

Addresses

Primary practice location

126 Phoenix Ave
Lowell, MA 01852-4991

Mailing address

160 Merrimack St Unit 803
Haverhill, MA 01830-6162
Phone (978) 417-1600

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

LicenseStateTypeSpecialty
LCSW231035MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1790503753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 MERRIMACK ST UNIT 803",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306162",
            "telephone_number": "978-417-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 PHOENIX AVE",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018524991",
            "telephone_number": "978-863-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMERS",
        "first_name": "KANDACE",
        "middle_name": "PAIGE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LCSW231035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.