Healthcare Provider Details

I. General information

NPI: 1154488187
Provider Name (Legal Business Name): COMMUNITY ACTION COMMISSION OF FAYETTE COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 09/02/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 US ROUTE 22 NW
WASHINGTON COURT HOUSE OH
43160-1402
US

IV. Provider business mailing address

1400 US ROUTE 22 NW
WASHINGTON COURT HOUSE OH
43160
US

V. Phone/Fax

Practice location:
  • Phone: 740-335-7282
  • Fax: 740-335-6802
Mailing address:
  • Phone: 740-335-7282
  • Fax: 740-335-6802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LUCINDA JEAN BAUGHN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 740-335-7282