Provider Demographics
NPI:1952804916
Name:MCDANIEL, CANDACE N (MSW)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:N
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:
Other - Last Name:BACKMAN-MCDANIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10100 ELIDA RD
Mailing Address - Street 2:
Mailing Address - City:DELPHOS
Mailing Address - State:OH
Mailing Address - Zip Code:45833-9056
Mailing Address - Country:US
Mailing Address - Phone:419-695-8010
Mailing Address - Fax:419-695-0004
Practice Address - Street 1:4925 LACROSS RD STE 111
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-6512
Practice Address - Country:US
Practice Address - Phone:849-552-1220
Practice Address - Fax:843-552-0502
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-15
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty