Provider Demographics
NPI:1588104640
Name:SCHALIT, CANDICE COWARD
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:COWARD
Last Name:SCHALIT
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 1:2103 RAINTREE PL
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-7958
Mailing Address - Country:US
Mailing Address - Phone:954-559-8650
Mailing Address - Fax:
Practice Address - Street 1:2103 RAINTREE PL
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-7958
Practice Address - Country:US
Practice Address - Phone:954-559-8650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012427101Y00000X
GA101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor