Active NPI
Todd Stuart Derbyshire, BA
- Mental Health Counselor
- Middleboro, MA
National Provider Identifier
1033374947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 8644
- Practice address
- 165 E Grove St
Suite B
Middleboro, MA 02346-2737 - Phone
- (800) 273-6277
- NPI assigned
- Jul 21, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Mental Health Counselor | 101YM0800X | 8644 | MA | Primary |
Addresses
Primary practice location
165 E Grove St
Suite B
Middleboro, MA 02346-2737
Mailing address
165 E Grove St
Suite B
Middleboro, MA 02346-2737
Phone (800) 273-6277
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8644 | MA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psyched Group, LLC | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Counselor
- Middleboro, MA
- NPI 1386039105
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475539200000",
"number": "1033374947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 E GROVE ST",
"address_2": "SUITE B",
"city": "MIDDLEBORO",
"state": "MA",
"postal_code": "023462737",
"telephone_number": "800-273-6277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 E GROVE ST",
"address_2": "SUITE B",
"city": "MIDDLEBORO",
"state": "MA",
"postal_code": "023462737",
"telephone_number": "800-273-6277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERBYSHIRE",
"first_name": "TODD",
"middle_name": "STUART",
"name_prefix": "Mr.",
"credential": "BA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-21",
"last_updated": "2016-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "8644",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middleboro, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.