# CANDACE SAM, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609246347
- **Authorized official:** CANDACE SAM LICSW (SOCIAL WORKER)
- **Authorized official phone:** (702) 353-0952

## Contact information

- **Practice address:** 6101 HAVELOCK AVE, SUITE 2A, LINCOLN, NE 68507-1268
- **Practice address phone:** (702) 353-0952
- **Practice address fax:** (844) 329-1465
- **Mailing address:** 6101 HAVELOCK AVE, SUITE 2A, LINCOLN, NE 68507-1268
- **Mailing address phone:** (702) 353-0952
- **Mailing address fax:** (844) 329-1465

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 1483, 1611 | NE | Yes |

## Other

- **Enumeration date:** 10/06/2015
- **Last updated:** 02/09/2016