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General NPI Number Information
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NPI Number | 1265735302
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Entity Type | Individual
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Provider Name | CANDI L. GADISON LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/13/2010
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Last Update Date | 07/08/2022
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Provider Practice Location Address
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Address Line | 3613 WILLIAMS DR STE 302
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City | GEORGETOWN
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State | TX
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Zip | 78628-1369
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Country | US
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Telephone | 512-966-1074
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Fax |
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Provider Business Mailing Address
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Address Line | 936 W CLARK ST
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City | BARTLETT
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State | TX
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Zip | 76511-4076
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Country | US
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Telephone | 129-661-0745
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 51009
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License Number State | TX
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