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Organization

HEATHER FUDGE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HEATHER FUDGE LCSW (OWNER, PROVIDER)
(458) 331-0531
Entity
Organization

Contact information

Practice address
438 CHARNELTON ST STE 101, EUGENE, OR 97401-2760
(458) 331-0531
(541) 543-2525
Mailing address
PO BOX 11103, EUGENE, OR 97440-3303
(458) 331-0531

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500660658
OR
Enumeration date
11/10/2021
Last updated
08/19/2025
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