MEDICARE: CANDACE COGSWELL

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	101Y00000X	Counselor	98322	TX

General Provider Information

NPI Number	:	1336003268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDACE COGSWELL

Provider Business Mailing Address
First Line	:	1301 MARTIN LUTHER KING JR DR STE B
Second Line	:
City	:	ORANGE
State	:	TX
Zip	:	77630-9000
Country	:	US
Telephone Number	:	979-215-9123
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 MARTIN LUTHER KING JR DR STE B
Second Line	:
City	:	ORANGE
State	:	TX
Zip	:	77630-9000
Country	:	US
Telephone Number	:	979-215-9123
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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Directions to “ CANDACE COGSWELL ” Practice Location

Language	Start Address	Practice Location

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