Provider Demographics
NPI:1558608265
Name:MCMANIS, CANDICE L (LCSW)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:L
Last Name:MCMANIS
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 1:710 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SALTSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15681-1313
Mailing Address - Country:US
Mailing Address - Phone:724-545-8420
Mailing Address - Fax:
Practice Address - Street 1:793 OLD ROUTE 119 HWY N
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-1372
Practice Address - Country:US
Practice Address - Phone:724-465-5576
Practice Address - Fax:724-465-6379
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0186551041C0700X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical