Provider Demographics
NPI:1235487935
Name:MCFALLS, CANDIS (PSYD)
Entity Type:Individual
Prefix:
First Name:CANDIS
Middle Name:
Last Name:MCFALLS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 CENTRAL AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-6709
Mailing Address - Country:US
Mailing Address - Phone:706-364-3461
Mailing Address - Fax:706-364-3481
Practice Address - Street 1:2100 CENTRAL AVE STE 6
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6709
Practice Address - Country:US
Practice Address - Phone:706-364-3461
Practice Address - Fax:706-364-3481
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251S00000XAgenciesCommunity/Behavioral Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program