Healthcare Provider Details

I. General information

NPI: 1548846199
Provider Name (Legal Business Name): JOANNA CANDANEDO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 SOUTH AVE E BLDG A
CRANFORD NJ
07016-3266
US

IV. Provider business mailing address

4132 ATLANTA HWY STE 110-169
LOGANVILLE GA
30052-5285
US

V. Phone/Fax

Practice location:
  • Phone: 908-418-4246
  • Fax:
Mailing address:
  • Phone: 404-467-6516
  • Fax: 404-826-6583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06457000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW009619
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: