Provider Demographics
NPI:1619063971
Name:MCCANDIES, TRACY DENINE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:DENINE
Last Name:MCCANDIES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:DENINE
Other - Last Name:CALDWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:249 BILLINGSLEY RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1003
Mailing Address - Country:US
Mailing Address - Phone:704-339-5387
Mailing Address - Fax:704-331-0859
Practice Address - Street 1:249 BILLINGSLEY RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1003
Practice Address - Country:US
Practice Address - Phone:704-339-5387
Practice Address - Fax:704-331-0859
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC15081OtherHEALTH DEPARTMENT