Provider Demographics
NPI:1114483633
Name:JONES, CANDACE (EDD)
Entity Type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4324 CLARKE RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38141-6711
Mailing Address - Country:US
Mailing Address - Phone:901-218-0750
Mailing Address - Fax:
Practice Address - Street 1:7540 BRITNEYWOODS CIR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38002-7531
Practice Address - Country:US
Practice Address - Phone:901-265-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor