Provider Demographics
NPI:1043785090
Name:FUGETT, ERICK (MSW)
Entity Type:Individual
Prefix:
First Name:ERICK
Middle Name:
Last Name:FUGETT
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:ERICK
Other - Middle Name:L
Other - Last Name:FUGETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:10730 MIDLAND TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41102-9679
Mailing Address - Country:US
Mailing Address - Phone:606-618-0282
Mailing Address - Fax:
Practice Address - Street 1:10730 MIDLAND TRAIL RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41102-9679
Practice Address - Country:US
Practice Address - Phone:606-618-0282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical