Active NPI
Deja Denay Brockett
- Mental Health Counselor
- Lanham, MD
National Provider Identifier
1033934138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 4200 Forbes Blvd Ste 103
Lanham, MD 20706-4390 - Phone
- (301) 781-7885
- NPI assigned
- Nov 22, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
4200 Forbes Blvd Ste 103
Lanham, MD 20706-4390
Mailing address
3007 Spice Bush Rd
Laurel, MD 20724-2921
Phone (301) 974-7632
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732838400000",
"number": "1033934138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3007 SPICE BUSH RD",
"city": "LAUREL",
"state": "MD",
"postal_code": "207242921",
"telephone_number": "301-974-7632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 FORBES BLVD STE 103",
"city": "LANHAM",
"state": "MD",
"postal_code": "207064390",
"telephone_number": "301-781-7885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROCKETT",
"first_name": "DEJA",
"middle_name": "DENAY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-11-22",
"last_updated": "2024-11-29",
"certification_date": "2024-11-29",
"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": []
}
Other providers in Lanham, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.