Provider Demographics
NPI:1396920070
Name:REUSSER, HUGH FREDRICK (MSW)
Entity type:Individual
Prefix:MR
First Name:HUGH
Middle Name:FREDRICK
Last Name:REUSSER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15030 MCDUFFEE RD
Mailing Address - Street 2:
Mailing Address - City:CHURUBUSCO
Mailing Address - State:IN
Mailing Address - Zip Code:46723-9432
Mailing Address - Country:US
Mailing Address - Phone:260-426-5431
Mailing Address - Fax:260-426-5431
Practice Address - Street 1:2121 LAKE AVE
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-5100
Practice Address - Country:US
Practice Address - Phone:260-460-1456
Practice Address - Fax:260-421-1029
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003771A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical