Jennifer Derrick

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

7330 Fern Ave Ste 1003
Shreveport, LA 71105-4988

Phone

(318) 759-7876

NPI assigned

Dec 9, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1013676741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7330 FERN AVE STE 1003",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 FERN AVE STE 1003",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054988",
            "telephone_number": "318-759-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICK",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dependable Care Services
• Allison Louise Derise, MD
• Dermatology & Skin Cancer Specialists, LLC
• Dermatology and Skin Surgery Apmc
• Alyssa Derouen
• Kristy Derrick, MS,RD,LD,CNSC
• Evelyn Derry, PH.D.
• Darcelle Deruise
• Anand M. Desai, MD
• Himanshu Desai, MD

• All providers in Shreveport, LA
• Mental Health Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.