Henry Fuqua, CADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

119050 Issued in KY

Practice address

1675 Story Ave
Louisville, KY 40206-1739

Phone

(502) 749-6344

Fax

(502) 749-6344

NPI assigned

Jan 14, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• A Vision for You Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Louisville, KY
  • NPI 1669241873

  Addiction (Substance Use Disorder)

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1285445841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 STORY AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402061739",
            "telephone_number": "502-749-6344",
            "fax_number": "502-749-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 STORY AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402061739",
            "telephone_number": "502-749-6344",
            "fax_number": "502-749-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUQUA",
        "first_name": "HENRY",
        "name_prefix": "Mr.",
        "credential": "CADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "119050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED ALCOHOL & DRUG CONSOLER LICENSE #",
            "identifier": "119050",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Functional Therapy, PLLC
• Kelli Carpenter Funk, PHARM.D.
• Natalie Funk
• Christine A. Funkhouser, PT
• Eric Quinn Fuqua, RADPSS
• Jacob Fuqua
• Carolyn Furdek, DPT
• Jamie Michelle Furlong-Dillard, D.O
• Stephen Matthew Furlow I, M.D.
• Christian Davis Furman, MD

• Addiction (Substance Use Disorder) Counselor in Louisville, KY
• Providers in Louisville, KY by specialty
• Addiction (Substance Use Disorder) Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.