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NPI Code Detail

MEDICARE: MRS. CANDICE MCDOWELL CARTNER LPC, MA, NCC

MEDICARE: MRS. CANDICE MCDOWELL CARTNER LPC, MA, NCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor8457NC

General Provider Information

NPI Number : 1063781078
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CANDICE MCDOWELL CARTNER LPC, MA, NCC
Provider Business Mailing Address
First Line : 5033 SELENA ST
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27106-2328
Country : US
Telephone Number : 828-551-2976
Fax Number :
Provider Business Practice Location Address
First Line : 4140 CHERRY ST
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27105-2536
Country : US
Telephone Number : 828-551-2976
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2011
Last Update Date : 03/30/2015

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