DR. CANDACE LOUISE MARTIN (NPI# 1114137080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114137080 |
| Entity Type | Individual |
| Full Name | DR. CANDACE LOUISE MARTIN |
| Credential | PSY.D. |
| Practice Address |
6319 Constitution Dr Fort Wayne IN 46804-1547 |
| Practice Telephone | 2604324346 |
| Practice Fax Number | 2604324860 |
| Mailing Telephone | 2604324346 |
| Mailing Fax Number | 2604324860 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 20040983A | IN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043435860 | Candace Clark Martin | Psychologist | 470 W End Ave # 1aa, New York, NY 10024-4933 | 2007-04-16 |
| 1396187738 | Candace Clay Martin | Counselor | 2420 Fannin St, Houston, TX 77002-9114 | 2013-07-26 |
| 1245261627 | Candace M Martin | Psychologist | 1061 Harmon Ave Ste 1d03, Winn Army Community Hospital, Fort Stewart, GA 31314-5674 | 2006-07-05 |
| Street Address |
6319 CONSTITUTION DR |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-1547 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457998007 | Ne Psychological LLC | Psychologist | 6343 Constitution Dr, Fort Wayne, IN 46804-1547 | 2019-12-03 |
| 1871032862 | Fort Wayne Neuropsychology LLC | Psychologist | 4306 E State Blvd, Fort Wayne, IN 46815-6915 | 2017-02-23 |
| 1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
| 1942555628 | Erin R. Bowman | Psychologist | 9910 Dupont Circle Dr E Ste 140, Fort Wayne, IN 46825-1618 | 2012-07-18 |
| 1548420474 | Marla J Souder | Psychologist | 11141 Parkview Plaza Dr Ste 210, Fort Wayne, IN 46845-1714 | 2008-06-13 |
| 1891954665 | Rachel Mae Miller | Psychologist | 1300 Airport North Office Park, Fort Wayne, IN 46825-6716 | 2008-06-05 |
| 1265691257 | Cook Behavioral Health Clinic, PC | Psychologist | 7230 Engle Rd Ste 304, Fort Wayne, IN 46804-2209 | 2008-06-04 |
| 1134344823 | Mary E Locke Phd Hspp LLC | Psychologist | 7337 W Jefferson Blvd Ste 175, Fort Wayne, IN 46804-6286 | 2007-04-16 |
| 1891818126 | John F Newbauer | Psychologist | 10008 Saint Clairs Retreat, Fort Wayne, IN 46825-2025 | 2007-04-10 |
| 1720145774 | Hutner, Inc. | Psychologist | 3240 Mallard Cove Ln, Fort Wayne, IN 46804-2883 | 2007-01-02 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.