DERRELL ANTHONY FUQUA SR. CDCA
NPI 1780158444
Counselor - Addiction (Substance Use Disorder) in Dayton, OH

Q: What is Derrell Fuqua's NPI number?

The NPI number for Derrell Fuqua is 1780158444. It was assigned to this individual provider in the NPPES registry on January 16, 2019.

Q: What is Derrell Fuqua's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Derrell Fuqua was last updated on January 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 16, 2019

2529 BRIDGEPORT DR, DAYTON, OH 45406(937) 278-0869 Get Directions Write a Review

NPPES record last updated: January 16, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Derrell Anthony Fuqua Sr. Cdca NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERRELL ANTHONY FUQUA SR. CDCA (NPI 1780158444) is an individual addiction (substance use disorder) provider in Dayton, Ohio, licensed in Ohio (169214) and active in the NPI registry since January 2019.

NPPES Registry Identity

NPI1780158444

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameDERRELL ANTHONY FUQUA SR.Credential: CDCA

Location Address2529 BRIDGEPORT DRDayton, OH 45406-1433

Mailing Address2529 Bridgeport DrDayton, OH 45406-1433 · (937) 278-0869

Phone(937) 278-0869

Sole ProprietorYes

Enumeration DateJanuary 16, 2019

✔ NPI 1780158444 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in OH · 169214

2529 BRIDGEPORT DR, Dayton, OH 45406

Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derrell Fuqua's NPI number?

The NPI number for Derrell Fuqua is 1780158444. It was assigned to this individual provider in the NPPES registry on January 16, 2019.

Where is Derrell Fuqua located?

Derrell Fuqua practices at 2529 Bridgeport Dr, Dayton, OH 45406. The listed phone number is (937) 278-0869.

What is Derrell Fuqua's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Derrell Fuqua was last updated on January 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.