Provider Demographics
NPI:1205430618
Name:CANDID NETWORK, INC.
Entity type:Organization
Organization Name:CANDID NETWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANI
Authorized Official - Middle Name:
Authorized Official - Last Name:NEALY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:405-476-2722
Mailing Address - Street 1:PO BOX 313
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:OK
Mailing Address - Zip Code:73084-0313
Mailing Address - Country:US
Mailing Address - Phone:405-476-2722
Mailing Address - Fax:833-824-1671
Practice Address - Street 1:3500 SPENCER RD
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:OK
Practice Address - Zip Code:73084-3237
Practice Address - Country:US
Practice Address - Phone:405-925-4220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health