Provider Demographics
NPI:1982937389
Name:CANDELL, HEIDI (LCSW)
Entity Type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:
Last Name:CANDELL
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 1:30 INNES ROAD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583
Mailing Address - Country:US
Mailing Address - Phone:914-423-4433
Mailing Address - Fax:914-423-9434
Practice Address - Street 1:487 S BROADWAY # 220
Practice Address - Street 2:C/O WJCS
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-3269
Practice Address - Country:US
Practice Address - Phone:914-423-4433
Practice Address - Fax:914-423-9434
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081027104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400095838Medicare PIN