Healthcare Provider Details

I. General information

NPI: 1699605287
Provider Name (Legal Business Name): CANDACE CLARRY COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N MAIN ST
SEVEN MILE OH
45062-5000
US

IV. Provider business mailing address

400 N MAIN ST
SEVEN MILE OH
45062-5000
US

V. Phone/Fax

Practice location:
  • Phone: 760-402-1822
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CANDACE MARY CLARRY
Title or Position: LISW
Credential: CLARRY
Phone: 760-402-1822