Healthcare Provider Details

I. General information

NPI: 1124306493
Provider Name (Legal Business Name): CANDICE CORINNE FIFER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2011
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 CORBINS CLOSE
WYOMING DE
19934-2377
US

IV. Provider business mailing address

120 CORBINS CLOSE
WYOMING DE
19934-2377
US

V. Phone/Fax

Practice location:
  • Phone: 302-535-6677
  • Fax: 302-351-6746
Mailing address:
  • Phone: 302-535-6677
  • Fax: 302-351-6746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0001098
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: