MEDICARE: CANDACE C FUDA LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C008355	NC

General Provider Information

NPI Number	:	1285076703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDACE C FUDA LCSW

Provider Business Mailing Address
First Line	:	2817 ROCK MERRITT AVE STOP A
Second Line	:	WOMACK ARMY MEDICAL CENTER
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-7324
Country	:	US
Telephone Number	:	910-907-8922
Fax Number	:	910-907-6069

Provider Business Practice Location Address
First Line	:	2817 ROCK MERRITT AVENUE STOP A
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	910-907-9075
Fax Number	:	910-907-6147

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2013
Last Update Date	:	12/16/2025

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