Healthcare Provider Details

I. General information

NPI: 1316858947
Provider Name (Legal Business Name): LORI FUQUA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 N MAIN STREET EXT
BUTLER PA
16001
US

IV. Provider business mailing address

PO BOX 756
EAST BUTLER PA
16029
US

V. Phone/Fax

Practice location:
  • Phone: 724-234-1370
  • Fax: 724-841-0343
Mailing address:
  • Phone: 412-546-2604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC020918
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: