MEDICARE: CANDOR THERAPY NETWORK PLLC

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
1	1041C0700X	Clinical Social Worker
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1164137006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANDOR THERAPY NETWORK PLLC

Provider Business Mailing Address
First Line	:	112 N ARTHUR ASHE BLVD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23220-4304
Country	:	US
Telephone Number	:	703-249-9890
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 N ARTHUR ASHE BLVD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23220-4304
Country	:	US
Telephone Number	:	703-249-9890
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST AND CO-OWNER
Name	:	MEGAN DAVIDSON
Credential	:	LPC, MED
Telephone Number	:	703-249-9890

Provider Enumeration Date	:	01/16/2023
Last Update Date	:	06/26/2025

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