Debra Fudge, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

30719 Issued in TX

Practice address

36000 Darnall Loop
Carl R. Darnall Army Medical Center
Ft Hood, TX 76544

Phone

(254) 288-8000

NPI assigned

Nov 6, 2008

Last updated

Nov 6, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225929600000",
    "number": "1679727580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36000 DARNALL LOOP",
            "address_2": "CARL R. DARNALL ARMY MEDICAL CENTER",
            "city": "FT HOOD",
            "state": "TX",
            "postal_code": "76544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36000 DARNALL LOOP",
            "address_2": "CARL R. DARNALL ARMY MEDICAL CENTER",
            "city": "FT HOOD",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "254-288-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUDGE",
        "first_name": "DEBRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2008-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "30719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clifford David Friesen, M. D.
• Peter Frohman, PH.D.
• Ramon E. Fry II, PA
• Sara Fry, MD
• Ibifiri Stella Fubara
• Everett Tomio Fuller, MD
• Jamison Eli Gaddy, PA-C
• Susan Jennifer Gallup, RN,MSN,CPNP
• Kimberly Ann Galvan, PA-C
• Mariano Francisco Gamarra Olivera, PA

• Clinical Social Worker in Fort Hood, TX
• Providers in Fort Hood, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.