Provider Demographics
NPI:1265195424
Name:FUINO, ALISHA A (MSW, LCSW, APHSW-C)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:A
Last Name:FUINO
Suffix:
Gender:F
Credentials:MSW, LCSW, APHSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 N LEBANON ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-1716
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:610 N LEBANON ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052-1716
Practice Address - Country:US
Practice Address - Phone:765-680-0071
Practice Address - Fax:765-436-0455
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2023-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34009399A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300056823Medicaid