Provider Demographics
NPI:1134271489
Name:HARRIS, CANDACE A (LCSW)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:A
Last Name:HARRIS
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 1:2516 S FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-7224
Mailing Address - Country:US
Mailing Address - Phone:303-668-4327
Mailing Address - Fax:303-722-1455
Practice Address - Street 1:3801 E FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-2571
Practice Address - Country:US
Practice Address - Phone:303-668-4327
Practice Address - Fax:303-722-1455
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9929711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical