Peggy S. Derivan, MS, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

000654-1 Issued in NY

Practice address

590 Titus Ave
Rochester, NY 14617

Phone

(585) 766-3082

NPI assigned

Dec 28, 2007

Last updated

Nov 2, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Peggy S Gold Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Discoveries Counseling and Wellness Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rochester, NY
  • NPI 1144091620
  NPD Authorized official

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509580800000",
    "number": "1073797833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 TITUS AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14617",
            "telephone_number": "585-766-3082",
            "fax_number": "585-266-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 TITUS AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14617",
            "telephone_number": "585-766-3082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERIVAN",
        "first_name": "PEGGY",
        "middle_name": "S.",
        "name_prefix": "Ms.",
        "credential": "MS, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-28",
        "last_updated": "2017-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "000654-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PEGGY",
            "last_name": "GOLD",
            "middle_name": "S",
            "credential": "MS, LMHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rhaissa Derby, DO
• Edward A Derck, DOCTORATE OF PHARMAC
• Derden LLC
• Edie L Derian, M.D.
• Vincent Evan Derienzo, PA
• Meghan Rose Derleth, MD
• Joanne Antinore Dermady, MS, NCC, LMHC, CEAP
• Dermatology &Cosmetic Center of Rochester
• Dermatology and Cosmetic Practice of Rochester PLLC
• Dermatology Associates of Rochester, PC

• Mental Health Counselor in Rochester, NY
• Providers in Rochester, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2017; 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.