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NPI Code Detail

MEDICARE: MRS. CANDACE R DESSER LCSW

MEDICARE: MRS. CANDACE R DESSER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerSW013706LPA
21041C0700XClinical Social WorkerCW016905PA

General Provider Information

NPI Number : 1578758702
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CANDACE R DESSER LCSW
Provider Business Mailing Address
First Line : 3910 CAUGHEY RD STE 200
Second Line :
City : ERIE
State : PA
Zip : 16506-4098
Country : US
Telephone Number : 814-315-3331
Fax Number :
Provider Business Practice Location Address
First Line : 3910 CAUGHEY RD STE 200
Second Line :
City : ERIE
State : PA
Zip : 16506-4098
Country : US
Telephone Number : 814-315-3331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2007
Last Update Date : 03/17/2024

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