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NPI Code Detail

MEDICARE: CANDACE NICOLE HOWARD

MEDICARE: CANDACE NICOLE HOWARD
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
1101YM0800XMental Health CounselorLPC010803GA
2101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1639638935
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDACE NICOLE HOWARD
Provider Business Mailing Address
First Line : 1638 BATTLEFIELD PKWY
Second Line :
City : FORT OGLETHORPE
State : GA
Zip : 30742-4016
Country : US
Telephone Number : 706-841-0500
Fax Number : 706-841-0502
Provider Business Practice Location Address
First Line : 1638 BATTLEFIELD PKWY
Second Line :
City : FORT OGLETHORPE
State : GA
Zip : 30742-4016
Country : US
Telephone Number : 706-841-0500
Fax Number : 706-841-0502
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2019
Last Update Date : 08/24/2023

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