1063781078 NPI number — MRS. CANDICE MCDOWELL CARTNER LPC, MA, NCC

Table of content: MRS. CANDICE MCDOWELL CARTNER LPC, MA, NCC (NPI 1063781078)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063781078 NPI number — MRS. CANDICE MCDOWELL CARTNER LPC, MA, NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARTNER
Provider First Name:
CANDICE
Provider Middle Name:
MCDOWELL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC, MA, NCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCDOWELL
Provider Other First Name:
CANDICE
Provider Other Middle Name:
ASHTON
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC, MA, NCC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1063781078
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/30/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5033 SELENA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINSTON SALEM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27106-2328
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-551-2976
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4140 CHERRY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINSTON SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27105-2536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-551-2976
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/20/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  8457 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com