Provider Demographics
NPI:1588470405
Name:BARKER, CANDICE
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:BARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3306 LITTLEPORT LN NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-6971
Mailing Address - Country:US
Mailing Address - Phone:423-284-6173
Mailing Address - Fax:
Practice Address - Street 1:2487 CEDARCREST RD STE 722
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-2730
Practice Address - Country:US
Practice Address - Phone:678-631-9907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health