Candy Chanel Arwine

Key facts

NPI

1922824176

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Analyst 103K00000X

License

24-389764 (TN)

Practice address

200 W Martin Luther King Blvd Ste 1000
Chattanooga, TN 37402-2571

Phone

(305) 345-7923

NPI assigned

Dec 3, 2024

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 3, 2024.

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1922824176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 WALNUT ST APT 449",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374034609",
            "telephone_number": "305-345-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W MARTIN LUTHER KING BLVD STE 1000",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374022571",
            "telephone_number": "305-345-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARWINE",
        "first_name": "CANDY CHANEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TN",
            "license": "24-389764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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