Provider Demographics
NPI:1871281105
Name:MCEVOY, CANDACE (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:MCEVOY
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 YORK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-3727
Mailing Address - Country:US
Mailing Address - Phone:651-900-9900
Mailing Address - Fax:
Practice Address - Street 1:7203 PERRY CT E
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-1202
Practice Address - Country:US
Practice Address - Phone:651-900-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical