Provider Demographics
NPI:1013088988
Name:TENCZAR, CANDACE (LICSW)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:TENCZAR
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 UNION ST STE 101
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-4100
Mailing Address - Country:US
Mailing Address - Phone:413-531-9409
Mailing Address - Fax:413-369-6083
Practice Address - Street 1:123 UNION ST STE 101
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-4100
Practice Address - Country:US
Practice Address - Phone:413-531-9409
Practice Address - Fax:413-369-6083
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA120473101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health