Individual provider Active NPI

Candis A Rose, M.A.

  • Mental Health Counselor
  • Springfield, MA
National Provider Identifier
1902998669
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
273 State St
Springfield, MA 01103-1950
Phone
(413) 736-3668
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

273 State St
Springfield, MA 01103-1950

Mailing address

814 Grayson Dr
Springfield, MA 01119-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240124000679 MA Practitioner - Mental Health Counselor 0446602635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Behavioral Health Network IncGroup PAC ID 3072596360, 146 clinicians

Practice addresses (Care Compare)

417 Liberty St
Springfield, MA 01104-3736
Phone (413) 736-3668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Network, Inc CurrentSince Jan 1, 2024 Accepting new patients
Behavioral Health Network Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

40 Bobala Rd
Holyoke, MA 01040
Phone (413) 536-5473

273 State St
Springfield, MA 01103
Phone (413) 736-3668

417 Liberty St
Springfield, MA 01104
Phone (413) 733-6661

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902998669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 GRAYSON DR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011191500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "273 STATE ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031950",
            "telephone_number": "413-736-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "CANDIS",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.