Provider Demographics
NPI:1467431619
Name:FIELDER, CANDACE JOAN (LSCSW)
Entity Type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:JOAN
Last Name:FIELDER
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:CONCORDIA
Mailing Address - State:KS
Mailing Address - Zip Code:66901-5200
Mailing Address - Country:US
Mailing Address - Phone:732-747-1400
Mailing Address - Fax:732-747-1400
Practice Address - Street 1:1836 M ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:KS
Practice Address - Zip Code:66935-2206
Practice Address - Country:US
Practice Address - Phone:785-527-2549
Practice Address - Fax:785-587-4377
Is Sole Proprietor?:No
Enumeration Date:2006-01-14
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC059002661041C0700X
KS41391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical