Provider Demographics
NPI:1043877087
Name:PRANGER, CANDACE L (LCSW)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:L
Last Name:PRANGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4595 TOWNE LAKE PKWY
Mailing Address - Street 2:300-130
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-5514
Mailing Address - Country:US
Mailing Address - Phone:404-661-2417
Mailing Address - Fax:
Practice Address - Street 1:4595 TOWNE LAKE PKWY
Practice Address - Street 2:300-130
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-5514
Practice Address - Country:US
Practice Address - Phone:404-661-2417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-24
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0067071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical