Healthcare Provider Details
I. General information
NPI: 1164137006
Provider Name (Legal Business Name): CANDOR THERAPY NETWORK PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/16/2023
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
112 N ARTHUR ASHE BLVD
RICHMOND VA
23220-4304
US
IV. Provider business mailing address
112 N ARTHUR ASHE BLVD
RICHMOND VA
23220-4304
US
V. Phone/Fax
- Phone: 703-249-9890
- Fax:
- Phone: 703-249-9890
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MEGAN
DAVIDSON
Title or Position: THERAPIST AND CO-OWNER
Credential: LPC, MED
Phone: 703-249-9890