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DERRELL ANTHONY FUQUA CDCA NPI 1780158444


NPI Information

NPI: 1780158444
Provider Name: DERRELL ANTHONY FUQUA, CDCA
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
2529 BRIDGEPORT DR
DAYTON, OH
ZIP 45406
Phone: (937) 278-0869
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Derrell Anthony Fuqua, CDCA is an addiction (substance use disorder) counselor in Dayton, OH. Derrell Anthony Fuqua, CDCA NPI is 1780158444. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2529 BRIDGEPORT DR
DAYTON, OH
ZIP 45406-433
Phone: (937) 278-0869

The enumeration date for this NPI number is 1/16/2019 and was last updated on 1/16/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YA0400XCounselorAddiction (Substance Use Disorder)169214OHIOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.