Individual
CANDISE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2505 COURT DR, GASTONIA, NC 28054-2140
(704) 842-6359
(704) 854-4860
Mailing address
2505 COURT DR, GASTONIA, NC 28054-2140
(704) 842-6359
(704) 854-4860
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSAC 2256
NC
251S00000X
Community/Behavioral Health Agency
202493799
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2535
NCSAPPB
NC
01
—
CSAC2256
NC SUBSTANCE ABUSE LICENSING BOARD
NC
Enumeration date
03/23/2016
Last updated
04/05/2016
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