Provider Demographics
NPI:1588477251
Name:SPAID, CANDICE R
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:R
Last Name:SPAID
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:PO BOX 299
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757-0299
Mailing Address - Country:US
Mailing Address - Phone:304-359-2185
Mailing Address - Fax:304-359-2306
Practice Address - Street 1:134 W SIOUX LN
Practice Address - Street 2:
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757-1459
Practice Address - Country:US
Practice Address - Phone:304-359-2185
Practice Address - Fax:304-359-2306
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator