Individual provider Active NPI

Sarah Derosa

  • Mental Health Counselor
  • Royal Palm Beach, FL
National Provider Identifier
1073059598
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH19693 Issued in FL
Practice address
1402 Royal Palm Beach Blvd Ste 400B
Royal Palm Beach, FL 33411-1692
Phone
(561) 792-9242
Fax
(561) 792-9243
NPI assigned
Jan 7, 2017
Last updated
Jul 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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 IMH19693 FL Primary

Addresses

Primary practice location

1402 Royal Palm Beach Blvd Ste 400B
Royal Palm Beach, FL 33411-1692

Mailing address

1402 Royal Palm Beach Blvd Ste 400B
Royal Palm Beach, FL 33411-1692
Phone (561) 792-9242

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

State licenses

LicenseStateTypeSpecialty
IMH19693FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ingram and Associates Counseling and Consulting, Inc. Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

1402 Royal Palm Beach Blvd
Ste 400B
Royal Palm Beach, FL 33411
Phone (561) 792-9242

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

NPI Registry JSON

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

{
    "created_epoch": "1483747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1073059598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 ROYAL PALM BEACH BLVD STE 400B",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334111692",
            "telephone_number": "561-792-9242",
            "fax_number": "561-792-9243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 ROYAL PALM BEACH BLVD STE 400B",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334111692",
            "telephone_number": "561-792-9242",
            "fax_number": "561-792-9243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSA",
        "first_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-07",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH19693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.