Candice Vida Coulter, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

11636 Issued in NC

Practice address

9929 Rea Rd
Ste 201
Waxhaw, NC 28173

Phone

(704) 316-1650

Fax

(704) 316-1651

NPI assigned

Mar 4, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: ccoulter703731@direct.novanthealth.org

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.

• A Child'S Perspective Child and Adolescent Counseling Services PLLC

  • Professional Counselor
  • Charlotte, NC
  • NPI 1912653676
  NPD

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1881152403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-316-1650",
            "fax_number": "704-316-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9929 REA RD",
            "address_2": "STE 201",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "28173",
            "telephone_number": "704-316-1650",
            "fax_number": "704-316-1651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9929 Rea Road",
            "address_2": "#201",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28173",
            "country_code": "US",
            "telephone_number": "704-316-1650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COULTER",
        "first_name": "CANDICE",
        "middle_name": "VIDA",
        "credential": "LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-04",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "11636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccoulter703731@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "9929 Rea Road",
            "address_2": "#201",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Neha Contractor
• Madelyn Healy Cook
• Jennifer Walker Cooney, LPC, NCC
• Debra L Corbett, MS, NCC, LPC
• Caroline Corzine, LCSW
• Sharon Cox
• Caitlyn Riley Crawford, PT, DPT
• Ellen Crean, OTR/L
• Alicia Victoria Crouch-Kozlowski, MS, OTR/L
• Christine Marie Cruse

• Professional Counselor in Waxhaw, NC
• Providers in Waxhaw, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.