Provider Demographics
NPI:1144293770
Name:GOOD, CANDACE R (MD)
Entity type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:R
Last Name:GOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:JEAN
Other - Last Name:RIEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:320 ROLLING RIDGE DR STE 203
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7641
Mailing Address - Country:US
Mailing Address - Phone:814-682-3880
Mailing Address - Fax:814-682-3881
Practice Address - Street 1:320 ROLLING RIDGE DR STE 203
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7641
Practice Address - Country:US
Practice Address - Phone:814-682-3880
Practice Address - Fax:814-682-3881
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD073835L2084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA19436290005Medicaid
PAH79717Medicare UPIN