Active NPI
Terri C Dierkes, LMSW
- Mental Health Counselor
- Fairfield, CT
National Provider Identifier
1073405478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 10949
- Practice address
- 71 Richard PL
Fairfield, CT 06824-2245 - Phone
- (650) 740-3748
- NPI assigned
- Jul 18, 2025
- Sex
- Female
- Sole proprietor
- No
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 | 10949 | CT | Primary |
Addresses
Primary practice location
71 Richard PL
Fairfield, CT 06824-2245
Mailing address
71 Richard PL
Fairfield, CT 06824-2245
Phone (650) 740-3748
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10949 | CT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752796800000",
"number": "1073405478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "71 RICHARD PL",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068242245",
"telephone_number": "650-740-3748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 RICHARD PL",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068242245",
"telephone_number": "650-740-3748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIERKES",
"first_name": "TERRI",
"middle_name": "C",
"name_prefix": "Mrs.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-18",
"last_updated": "2025-07-18",
"certification_date": "2025-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CT",
"license": "10949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.