CANDICE BLACKBURN HENDERSON (NPI# 1033414974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033414974 |
| Entity Type | Individual |
| Full Name | CANDICE BLACKBURN HENDERSON |
| Other Name | CANDICE MICHELLE BLACKBURN |
| Credential | LPCC |
| Practice Address |
708 Westport Rd Elizabethtown KY 42701-3819 |
| Practice Telephone | (270) 766-1234 |
| Mailing Telephone | (270) 766-1234 |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | KY-1256 | KY | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
KY-1256 | KY | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 333 W Dixie Ave, Elizabethtown, KY 427011757 | 2707696846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831592054 | Candice Henderson | Specialist | 1141 Hollywood Rd Apt B, Linden, NJ 07036-5629 | 2014-10-01 |
| Street Address |
708 WESTPORT RD |
| City | ELIZABETHTOWN |
| State | KY |
| Zip Code | 42701-3819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063410231 | Russell Lynn Mckinley | Podiatrist | 708 Westport Rd, Suite 102, Elizabethtown, KY 42701-3819 | 2005-07-12 |
| 1467925859 | Sn Kentuckiana Rehab, LLC | Clinic/Center | 708 Westport Rd, Elizabethtown, KY 42701-3819 | 2019-01-08 |
| 1982147153 | Julianne Matteson | Physical Therapist | 708 Westport Rd, Elizabethtown, KY 42701-3819 | 2016-11-21 |
| 1174065676 | Jacob Hughes | Physical Therapist | 708 Westport Rd, Elizabethtown, KY 42701-3819 | 2016-11-15 |
| 1144693631 | Michael Anthony Kidwell | Physical Therapist | 708 Westport Rd, 200, Elizabethtown, KY 42701-3819 | 2015-11-05 |
| 1083986954 | Deric Parrish | Physical Therapist | 708 Westport Rd, Suite 202, Elizabethtown, KY 42701-3819 | 2012-02-07 |
| 1437399037 | Suresh Kodali | Marriage & Family Therapist | 708 Westport Rd, Suite 103, Elizabethtown, KY 42701-3819 | 2009-02-23 |
| 1891933487 | Melissa Danielle Hawkins | Physical Therapist | 708 Westport Rd, Suite 201, Elizabethtown, KY 42701-3819 | 2009-02-04 |
| 1619185683 | Kentucky Orthopedic Rehabilitation | Durable Medical Equipment & Medical Supplies | 708 Westport Rd, Elizabethtown, KY 42701-3819 | 2007-05-21 |
| 1528270402 | Advanced Foot & Ankle Care LLC | Durable Medical Equipment & Medical Supplies | 708 Westport Rd, Suite 102, Elizabethtown, KY 42701-2866 | 2007-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693104 | James G. Thornton | Specialist/Technologist, Other | 2409 Ring Road, Suite 106, Elizabethtown, KY 42701 | 2020-09-11 |
| 1033720727 | Rebecca Williams | Pharmacist | 1602 N Dixie Highway, Elizabethtown, KY 42701 | 2020-08-14 |
| 1245855709 | Mckenzie Jo Clemons | Speech-Language Pathologist | 107 Financial Drive, Elizabethtown, KY 42701 | 2020-06-10 |
| 1215565825 | Christina Nichole Hobson | Peer Specialist | 413 E Dixie Ste 106, Elizabethtown, KY 42701 | 2020-03-30 |
| 1336701275 | Cassandra Elizabeth Baker | Nurse Practitioner | 2005 N. Dixie Highway, Elizabethtown, KY 42701 | 2019-07-01 |
| 1487134276 | Ryan Leon Hogan | Marriage & Family Therapist | 1106 Tunnel Hill Road, Suite 100, Elizabethtown, KY 42701 | 2018-08-21 |
| 1033623921 | Kayla Russell | Behavior Technician | 529 Westport Road, Elizabethtown, KY 42701 | 2017-11-30 |
| 1578087128 | Brenda Gale Nunn | Case Manager/Care Coordinator | 2600 Ring Road, Elizabethtown, KY 42701 | 2017-07-26 |
| 1013451277 | Chelsea Danielle Thorn | Nurse Practitioner | 2005 N. Dixie Hwy, Elizabethtown, KY 42701 | 2016-12-07 |
| 1003364597 | Joseph Michael Senay | Pharmacist | 521 Robinbrooke Dr., Cancer Care Center of Hardin Memorial Hospital, Elizabethtown, KY 42701 | 2016-09-14 |
| Find all providers in zip 42701 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265041115 | Tamathy Henderson | Counselor | 129b Howell Dr, Elizabethtown, KY 42701-3614 | 2020-07-27 |
| 1326673526 | Natasha Regina Porter | Counselor | 120 Meena Way Apt 3a, Elizabethtown, KY 42701-4826 | 2020-03-08 |
| 1295236149 | Tiffany Bufort | Counselor | 1890 N Market St, Elizabethtown, PA 17022-1131 | 2018-02-26 |
| 1356791750 | Brandy Heavrin | Counselor | 1106 Tunnel Hill Rd # 100, Elizabethtown, KY 42701-8067 | 2016-06-16 |
| 1023463254 | Michelle Marie Davy | Counselor | 40 W Hummelstown St, Elizabethtown, PA 17022-2021 | 2016-04-25 |
| 1235595901 | Terri Dugan | Counselor | 790 N Dixie Ave Ste B100, Elizabethtown, KY 42701-2488 | 2016-01-11 |
| 1770979379 | Erika Del Carmen Matzdorff | Counselor | 202 N Mulberry St, Elizabethtown, KY 42701-1441 | 2015-04-09 |
| 1427447473 | Charlotte Campbell Davis | Counselor | 1111 N Dixie Hwy Ste 2, Elizabethtown, KY 42701-2764 | 2015-01-14 |
| 1528475670 | Stephanie Bridgehouse | Counselor | 978 Milton Grove Rd N, Elizabethtown, PA 17022-8485 | 2014-07-21 |
| 1336470673 | Holly B Daknis | Counselor | 1311 N Dixie Hwy Bldg D, Elizabethtown, KY 42701-2621 | 2010-01-27 |
| Find all providers in ELIZABETHTOWN | ||||
| City | ELIZABETHTOWN |
| Zip Code | 42701 |
Please comment or provide details below to improve the information on CANDICE BLACKBURN HENDERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.