Individual provider Active NPI

Candace Jean Cowan, M.S.

  • Mental Health Counselor
  • Rockledge, FL
National Provider Identifier
1952407058
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH2161 Issued in FL
Practice address
845 Executive LN
Suite 100
Rockledge, FL 32955-3528
Phone
(321) 631-5538
Fax
(321) 631-5154
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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 MH2161 FL Primary

Addresses

Primary practice location

845 Executive LN
Suite 100
Rockledge, FL 32955-3528

Mailing address

5180 Pine St
Cocoa, FL 32927-2080
Phone (321) 634-5481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240124003483 FL Practitioner - Mental Health Counselor 9133572308 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MH2161FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Adult & Child Counseling and Psychiatric Center, P.a. Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Apr 10, 2024 Accepting new patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients

Locations

5545 N Wickham Rd
Ste 110
Melbourne, FL 32940
Phone (321) 452-5633

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Interoperability endpoints

  • Direct secure messaging: candacecowan@tdh.allscriptsdirect.net

Organizations & group practices 3

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1952407058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5180 PINE ST",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329272080",
            "telephone_number": "321-634-5481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 EXECUTIVE LN",
            "address_2": "SUITE 100",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553528",
            "telephone_number": "321-631-5538",
            "fax_number": "321-631-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWAN",
        "first_name": "CANDACE",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH2161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

Verify at the official NPI Registry.