Provider Demographics
NPI:1316511918
Name:GASPARD, CANDICE
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:GASPARD
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 1:140 WINDERMERE BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3583
Mailing Address - Country:US
Mailing Address - Phone:318-528-8679
Mailing Address - Fax:844-907-2983
Practice Address - Street 1:140 WINDERMERE BLVD STE C
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3583
Practice Address - Country:US
Practice Address - Phone:318-528-8679
Practice Address - Fax:844-907-2983
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator