Active NPI
Candis Jai Lavallais, LMHC, LPC
- Mental Health Counselor
- Dallas, TX
National Provider Identifier
1811685704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39004495A
- Practice address
- 6714 Keswick Dr
Dallas, TX 75232-3315 - Phone
- (317) 435-7184
- NPI assigned
- Apr 27, 2023
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39004495A | IN | Primary |
Addresses
Primary practice location
6714 Keswick Dr
Dallas, TX 75232-3315
Mailing address
6714 Keswick Dr
Dallas, TX 75232-3315
Phone (317) 435-7184
Other practice location 1
1135 S Main St
Grapevine, TX 76051-7533
Phone (817) 329-5041
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 92586 | Other | TX | TEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2014
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1935 Medical District Dr
Dallas, TX 75235-7794
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39004495A | IN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698624000000",
"number": "1811685704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6714 KESWICK DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752323315",
"telephone_number": "317-435-7184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6714 KESWICK DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752323315",
"telephone_number": "317-435-7184"
}
],
"practiceLocations": [
{
"address_1": "1135 S Main St",
"address_purpose": "LOCATION",
"city": "Grapevine",
"state": "TX",
"postal_code": "760517533",
"country_code": "US",
"telephone_number": "817-329-5041",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAVALLAIS",
"first_name": "CANDIS",
"middle_name": "JAI",
"credential": "LMHC, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-27",
"last_updated": "2023-10-30",
"certification_date": "2023-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39004495A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL",
"identifier": "92586",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.