Active NPI
Derek Price
- Professional Counselor
- Louisville, KY
National Provider Identifier
1083115695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC011610
- Practice address
- 4835 Poplar Level Rd Ste 110
Louisville, KY 40213-2906 - Phone
- (502) 443-5273
- NPI assigned
- Feb 28, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC011610 | GA | Primary |
Addresses
Primary practice location
4835 Poplar Level Rd Ste 110
Louisville, KY 40213-2906
Mailing address
125 Park of Commerce Dr Ste 116
Savannah, GA 31405-7489
Phone (912) 244-9361
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 |
|---|---|---|---|
| LPC011610 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736208000000",
"number": "1083115695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 PARK OF COMMERCE DR STE 116",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314057489",
"telephone_number": "912-244-9361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4835 POPLAR LEVEL RD STE 110",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402132906",
"telephone_number": "502-443-5273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRICE",
"first_name": "DEREK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-28",
"last_updated": "2025-01-07",
"certification_date": "2024-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC011610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.