Individual provider Active NPI

Candice Caddle, LPC

  • Professional Counselor
  • Suffolk, VA
National Provider Identifier
1962007740
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701010152 Issued in VA
Practice address
116 Independence CT
Suffolk, VA 23434-2369
Phone
(757) 285-3645
NPI assigned
Dec 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 0701010152 VA
Professional Counselor 101YP2500X 0701010152 VA Primary

Addresses

Primary practice location

116 Independence CT
Suffolk, VA 23434-2369

Mailing address

116 Independence CT
Suffolk, VA 23434-2369
Phone (757) 285-3645

Other practice location 1

548 Battlefield Blvd S Ste A
Chesapeake, VA 23322-5363
Phone (757) 359-8144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240410001204 VA Practitioner - Mental Health Counselor 0244678233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

116 Independence CT
Suffolk, VA 23434-2369
Phone (757) 359-8144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701010152VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
A Step to Healing CurrentSince Jan 31, 2024 Accepting new patients

Locations

548 Battlefield Blvd S
Ste A
Chesapeake, VA 23322
Phone (757) 277-9222

Organizations & group practices 1

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": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1962007740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 INDEPENDENCE CT",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234342369",
            "telephone_number": "757-285-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 INDEPENDENCE CT",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234342369",
            "telephone_number": "757-285-3645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "548 Battlefield Blvd S Ste A",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233225363",
            "country_code": "US",
            "telephone_number": "757-359-8144",
            "fax_number": "757-974-9383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CADDLE",
        "first_name": "CANDICE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VA",
            "license": "0701010152",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701010152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.