Individual provider Active NPI

Julia Allison Derouen, MA ED., NCC, LPC

  • Mental Health Counselor
  • Hendersonville, NC
National Provider Identifier
1063799476
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8835 Issued in NC
Practice address
120 Chadwick Square CT Ste C
Hendersonville, NC 28739-3200
Phone
(828) 696-2667
Fax
(828) 696-2031
NPI assigned
Nov 14, 2011
Last updated
Nov 14, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8835 NC Primary

Addresses

Primary practice location

120 Chadwick Square CT Ste C
Hendersonville, NC 28739-3200

Mailing address

131 Haywood Knolls Dr
Hendersonville, NC 28791-8705
Phone (828) 808-7673

Other identifiers 1

IdentifierTypeStateIssuer
8835OtherNCLICENSE PROFESSIONAL COUNSELOR

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
8835NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1063799476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 HAYWOOD KNOLLS DR",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287918705",
            "telephone_number": "828-808-7673",
            "fax_number": "828-696-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CHADWICK SQUARE CT STE C",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287393200",
            "telephone_number": "828-696-2667",
            "fax_number": "828-696-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROUEN",
        "first_name": "JULIA",
        "middle_name": "ALLISON",
        "name_prefix": "Mrs.",
        "credential": "MA ED., NCC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-14",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "8835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE PROFESSIONAL COUNSELOR",
            "identifier": "8835",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; 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.