CANDACE CLARK (NPI# 1629327101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629327101 |
| Entity Type | Individual |
| Full Name | CANDACE CLARK |
| Credential | PCC |
| Practice Address |
202 East Bagley Road Berea OH 44017-2058 |
| Practice Telephone | 8002342006 |
| Mailing Telephone | 8002342006 |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2012-08-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
E.0600652 | OH | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376166579 | Candace Ann Clark | Physician Assistant | 7237 Wellauer Dr, Wauwatosa, WI 53213-3665 | 2020-05-21 |
| 1821448820 | Candace Clark | Clinic/Center | 17008 Sw 39th St, Miramar, FL 33027-4614 | 2016-06-21 |
| 1609297431 | Candace Clark | Dietitian, Registered | 1615 Delware Street, Longview, WA 98632 | 2013-12-20 |
| 1437775095 | Candace Danielle Clark | Counselor | 4211 Government Blvd, Mobile, AL 36693-4813 | 2020-06-19 |
| 1619534203 | Candace Clark | Social Worker | 13136 Western Ave, Blue Island, IL 60406-2423 | 2019-05-20 |
| Street Address |
202 EAST BAGLEY ROAD |
| City | BEREA |
| State | OH |
| Zip Code | 44017-2058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174680557 | Ohioguidestone | Community/Behavioral Health | 202 East Bagley Road, Berea, OH 44017-2058 | 2007-01-03 |
| 1770611410 | Nancy L Schmitz | Psychologist | 202 East Bagley Road, Berea Children's Home and Family Services, Berea, OH 44017 | 2007-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023632759 | Faseeha Raza | Student in an Organized Health Care Education/Training Program | Baldwin Wallace University Physician Assistant Program, 201 Front Street, Berea, OH 44017 | 2020-05-28 |
| 1851885412 | Monica Lynne Mcfarland | Occupational Therapy Assistant | 570 North Rocky River Drive, Berea, OH 44017 | 2018-06-18 |
| 1700301207 | Cherelle Scott | Counselor | 398 W Bagley Road Ste, Suite 216, Berea, OH 44017 | 2017-08-07 |
| 1780042457 | Linda Lou Cummings | Social Worker | 202 E. Bagley Road, Berea, OH 44017 | 2016-02-09 |
| 1760827042 | Pathways Hospice LLC | Hospice Care, Community Based | 885 W. Bagley Road, Berea, OH 44017 | 2013-05-01 |
| 1336457134 | Mary Elizabeth Italiano-burke | Licensed Practical Nurse | 90 Emerson Dr., #11009, Berea, OH 44017 | 2010-09-15 |
| 1720260979 | Cooperative Medical Health Care Corporation Professional Association | Mechanotherapist | 165 W. Bagley Rd., Berea, OH 44017 | 2007-11-29 |
| 1326230616 | Marilyn Sue George | Psychoanalyst | 187 Seminary St, Berea, OH 44017 | 2007-08-10 |
| 1437371556 | Michael Charles Powell | Registered Nurse | 501 Nobottom Rd, Berea, OH 44017 | 2007-05-02 |
| 1538381439 | Paula Davis Fultz | Counselor | 303 E. Bagley Road, Berea, OH 44017 | 2007-05-02 |
| Find all providers in zip 44017 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285879205 | Carol J Stutts | Counselor | 108 Whispering Hills Dr, Berea, KY 40403-9753 | 2008-12-04 |
| 1376767640 | Carol Lynne Peachee | Counselor | 122 Main St Ste D, Ste D, Berea, KY 40403-1903 | 2007-04-11 |
| 1912030461 | Cynthia Louise Miller | Counselor | 285 E Bagley Rd, Berea, OH 44017-2038 | 2007-03-13 |
| 1598815565 | Michael P Lewis | Counselor | 1315 Gabbardtown Rd, Berea, KY 40403-9278 | 2007-01-11 |
| 1851999650 | Palm Wellness, LLC | Counselor | 429 Front St, Berea, OH 44017-1716 | 2020-10-14 |
| 1720579386 | Lauren Ware | Counselor | 202 E Bagley Rd, Berea, OH 44017-2058 | 2018-05-19 |
| 1104314152 | Angela Leek | Counselor | 202 E Bagley Rd, Berea, OH 44017-2058 | 2018-04-25 |
| 1699219196 | Monica M Mlinac | Counselor | 202 E Bagley Rd, Berea, OH 44017-2058 | 2016-12-19 |
| 1730634023 | Tonie R Horn | Counselor | 202 E Bagley Rd, Berea, OH 44017-2058 | 2016-08-17 |
| 1295183028 | Kerry W Copes | Counselor | 434 Eastland Rd, Berea, OH 44017-1217 | 2016-06-02 |
| Find all providers in BEREA | ||||
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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.