Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Derrell Anthony Fuqua Sr., CDCA

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1780158444

Derrell Anthony Fuqua Sr., CDCA is an Addiction (Substance Use Disorder) Counselor in Dayton, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2019

Practice location Address checks out

2529 Bridgeport Dr
Dayton, OH 45406-1433
Phone: (937) 278-0869
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 169214 (OH)

Record details

NPI number1780158444
Entity typeIndividual (Type 1)
GenderMale
Credentials CDCA
Sole proprietorYes
NPI enumeratedJanuary 16, 2019
Last updated in NPPESJanuary 16, 2019

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