Provider Demographics
NPI:1659796829
Name:MCCANDLESS, DAWN (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:
Last Name:MCCANDLESS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24401 MERRIMAC LN
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46517-3325
Mailing Address - Country:US
Mailing Address - Phone:574-238-7072
Mailing Address - Fax:
Practice Address - Street 1:58512 OLD COUNTY ROAD 17
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46528-8464
Practice Address - Country:US
Practice Address - Phone:574-875-5622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000888A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical