Provider Demographics
NPI:1962240572
Name:CANDEA, NANCY ANNE (LSW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ANNE
Last Name:CANDEA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 MERIDEN RD
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-1215
Mailing Address - Country:US
Mailing Address - Phone:808-885-9642
Mailing Address - Fax:
Practice Address - Street 1:239 NEW RD # 302
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-4274
Practice Address - Country:US
Practice Address - Phone:973-298-0763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07158100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker