Provider Demographics
NPI:1588742571
Name:RUTHERFORD, CANDACE L (LCSW)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:L
Last Name:RUTHERFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13457 MERCERSBURG RD
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:17225-8636
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:176 S COLDBROOK AVE
Practice Address - Street 2:UNIT 2
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2714
Practice Address - Country:US
Practice Address - Phone:717-267-7480
Practice Address - Fax:717-267-7403
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0134561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical