Provider Demographics
NPI:1144809930
Name:MOXEY, CANDACE DANIELLE (LMSW)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:DANIELLE
Last Name:MOXEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 MARION PEPE DR APT B
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-2875
Mailing Address - Country:US
Mailing Address - Phone:917-679-2760
Mailing Address - Fax:
Practice Address - Street 1:106 MARION PEPE DR APT B
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-2875
Practice Address - Country:US
Practice Address - Phone:917-679-2760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL065472001041C0700X
NY1056861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical