CANDACE KOTKIN-DECARVALHO (NPI# 1740896042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740896042 |
| Entity Type | Individual |
| Full Name | CANDACE KOTKIN-DECARVALHO |
| Credential | LCADC |
| Practice Address |
3 Corbett Way Eatontown NJ 07724-2283 |
| Practice Telephone | 7322100509 |
| Practice Fax Number | 7325421948 |
| Mailing Telephone | 7322100509 |
| Mailing Fax Number | 7325421948 |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2020-09-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
37LC00318700 | NJ | Behavioral Health & Social Service Providers |
| Street Address |
3 CORBETT WAY |
| City | EATONTOWN |
| State | NJ |
| Zip Code | 07724-2283 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073889358 | Advanced Health & Education | Community/Behavioral Health | 3 Corbett Way, Eatontown, NJ 07724-2283 | 2012-03-30 |
| 1629631627 | Jo Myman | Counselor | 3 Corbett Way, Eatontown, NJ 07724-2283 | 2019-04-16 |
| 1295209898 | Barbara A Rexer | Social Worker | 3 Corbett Way, Eatontown, NJ 07724-2283 | 2019-01-16 |
| 1891296067 | Michelle Burton | Counselor | 3 Corbett Way, Eatontown, NJ 07724-2283 | 2018-02-23 |
| 1326590571 | Lauren Emerson Simicich | Social Worker | 3 Corbett Way, Eatontown, NJ 07724 | 2016-11-03 |
| 1881077824 | Agnes Shanley | Massage Therapist | 3 Corbett Way, Eatontown, NJ 07724-2283 | 2015-07-08 |
| 1578989935 | Monmouth Behavioral Diagnostics, LLC | Clinical Medical Laboratory | 3 Corbett Way, Suite B, Eatontown, NJ 07724-2283 | 2014-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719788 | Zsanae Lewis | Driver | 1 Main St Unit 401, Eatontown, NJ 07724 | 2019-06-18 |
| 1417419169 | Refocus | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 613 Hope Road, Building 5 and 2, Eatontown, NJ 07724 | 2019-04-02 |
| 1215401575 | Angela Fordham-lewis | Day Training/Habilitation Specialist | 613 Hope Road, Building #2, Eatontown, NJ 07724 | 2019-01-18 |
| 1174094312 | Patti Kousoulis | Counselor | 10 Industrial Way East, Eatontown, NJ 07724 | 2018-12-16 |
| 1649745589 | Jersey Shore Dental Spa LLC | Dentist | 613 Hope Road Building 5, Eatontown, NJ 07724 | 2018-10-08 |
| 1487135448 | A2z Diagnostics LLC | Pathology | 6 Industrial Way W Ste F19, Eatontown, NJ 07724 | 2018-08-27 |
| 1942708268 | Elyce Jackson | Counselor | 10 Industrial Way, Eatontown, NJ 07724 | 2018-02-01 |
| 1477065894 | The Arc of Monmouth, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 36 Country Club Road Apt. 249, Eatontown, NJ 07724 | 2017-10-25 |
| 1639681059 | The Arc of Monmouth, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 36 Country Club Road Apt. 277, Eatontown, NJ 07724 | 2017-10-25 |
| 1669998100 | Seacrest Recovery Center North Jersey, LLC | Psychologist | 162 Highway 35, Eatontown, NJ 07724 | 2017-08-16 |
| Find all providers in zip 07724 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942354550 | Deborah Lynn Martin | Counselor | 111 Broad St, Eatontown, NJ 07724-1529 | 2007-01-22 |
| 1376141291 | Jennfer Marie Guzman | Counselor | 1 Corbett Way, Eatontown, NJ 07724-4247 | 2020-10-13 |
| 1003414939 | Matthew Steven Behrens | Counselor | 1 Corbett Way, Eatontown, NJ 07724-4247 | 2020-10-13 |
| 1629631627 | Jo Myman | Counselor | 3 Corbett Way, Eatontown, NJ 07724-2283 | 2019-04-16 |
| 1689144941 | James Rawlins Price | Counselor | 1 Corbett Way, Eatontown, NJ 07724-4247 | 2018-11-29 |
| 1962972315 | Nicole Martinez | Counselor | 1 Corbett Way, Eatontown, NJ 07724-4247 | 2018-11-28 |
| 1891296067 | Michelle Burton | Counselor | 3 Corbett Way, Eatontown, NJ 07724-2283 | 2018-02-23 |
| 1932646981 | Geraldine Viggiani | Counselor | 27 Main St, Eatontown, NJ 07724-3498 | 2017-01-30 |
| 1447596028 | Keith H Martinez | Counselor | 1 Corbett Way, Eatontown, NJ 07724-4247 | 2012-12-30 |
| 1548417694 | Sharon Moleski | Counselor | 56 Jamestown Rd, Eatontown, NJ 07724-2433 | 2008-08-20 |
| Find all providers in EATONTOWN | ||||
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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.