Provider Demographics
NPI:1457689036
Name:FRUCHEY, JOY DIANNE (MSW, LSW, CTS)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:DIANNE
Last Name:FRUCHEY
Suffix:
Gender:F
Credentials:MSW, LSW, CTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 N SHOOP AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:WAUSEON
Mailing Address - State:OH
Mailing Address - Zip Code:43567-1857
Mailing Address - Country:US
Mailing Address - Phone:419-335-6122
Mailing Address - Fax:419-318-4157
Practice Address - Street 1:1115 S SHOOP AVENUE
Practice Address - Street 2:
Practice Address - City:WAUSEON
Practice Address - State:OH
Practice Address - Zip Code:43567-1912
Practice Address - Country:US
Practice Address - Phone:419-335-6122
Practice Address - Fax:419-318-4157
Is Sole Proprietor?:No
Enumeration Date:2009-11-19
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0029688101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health