Provider Demographics
NPI:1487100129
Name:MCCANDLISH, CAROLYN ANNE (LCSW, LICSW)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ANNE
Last Name:MCCANDLISH
Suffix:
Gender:F
Credentials:LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4730 UNIVERSITY WAY NE
Mailing Address - Street 2:STE-104 #2050
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4424
Mailing Address - Country:US
Mailing Address - Phone:484-800-1706
Mailing Address - Fax:
Practice Address - Street 1:928 BROADWAY SUITE 500
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010
Practice Address - Country:US
Practice Address - Phone:484-800-1706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program