Healthcare Provider Details

I. General information

NPI: 1487472445
Provider Name (Legal Business Name): CANDACE NICOLE CURRY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 WISHARD BLVD STE 4110
INDIANAPOLIS IN
46202-4164
US

IV. Provider business mailing address

1002 WISHARD BLVD STE 4110
INDIANAPOLIS IN
46202-4164
US

V. Phone/Fax

Practice location:
  • Phone: 317-944-8162
  • Fax:
Mailing address:
  • Phone: 317-944-8162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34011309A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: