Healthcare Provider Details

I. General information

NPI: 1235298480
Provider Name (Legal Business Name): COMMUNITY ACTION COMMISSION OF FAYETTE COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 US ROUTE 22 NW
WASHINGTON COURT HOUSE OH
43160
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

VIII. Authorized Official

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