Derek Gabriel Cervantes

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPCC.0019910 Issued in CO

Practice address

1611 S Murray Blvd
Colorado Springs, CO 80916-4502

Phone

(719) 640-7089

NPI assigned

Nov 13, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1174347371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 S MURRAY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809164502",
            "telephone_number": "719-640-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 S MURRAY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809164502",
            "telephone_number": "719-640-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVANTES",
        "first_name": "DEREK",
        "middle_name": "GABRIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPCC.0019910",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Fernanda Ceron Umana
• Julissa Nicole Cerrato
• Certified Wound Care Solutions LLC
• Taylor Cervantes Anheuser, RBT
• Alberto Ramon Cervantes
• Jordan Cervantes, PHARMD DOCTORATE
• Dominik Cervantez
• Beatrice Louise Cerwinka
• Karin B Cesario, MD
• Jasmine Alice Cessna, PHARMD

• Mental Health Counselor in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.