Edward Deherrera, SUDPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

C061261876 Issued in WA

Practice address

140 S Arthur Street, Suite 400
Suite 400
Spokane, WA 99202-9920

Phone

(509) 532-8855

Fax

(509) 532-8844

NPI assigned

Apr 11, 2022

Last updated

Apr 11, 2022By the provider in NPPES

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

Other names 1

• Eddy Deherrera Other name

Electronic endpoints 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gateway Counseling Services

  • Addiction (Substance Use Disorder) Counselor
  • Spokane, WA
  • NPI 1336249010
  NPD (past)

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1053053934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 S ARTHUR ST STE 400",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022220",
            "telephone_number": "509-532-8855",
            "fax_number": "509-532-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 S ARTHUR STREET, SUITE 400",
            "address_2": "SUITE 400",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992029920",
            "telephone_number": "509-532-8855",
            "fax_number": "509-532-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHERRERA",
        "first_name": "EDWARD",
        "credential": "SUDPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-11",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "C061261876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE BILLING",
            "identifier": "CO61261876",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.gatewaycounseling.net",
            "affiliation": "N",
            "endpointDescription": "Company website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Website",
            "address_1": "140 S Arthur St Ste 400",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992022220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EDDY",
            "last_name": "DEHERRERA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Addiction (Substance Use Disorder) Counselor in Spokane, WA
• Providers in Spokane, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.