Derek Struchtemeyer, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

002981 Issued in GA

Practice address

310 Paper Trail Way Ste 106
Canton, GA 30115-5204

Phone

(678) 880-4645

NPI assigned

Oct 23, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Canton Counseling, LLC

  • Professional Counselor
  • Canton, GA
  • NPI 1780014720
  Medicare reassignment NPD

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382486400000",
    "number": "1215365663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 PAPER TRAIL WAY STE 106",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301155204",
            "telephone_number": "678-880-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 PAPER TRAIL WAY STE 106",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301155204",
            "telephone_number": "678-880-4645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRUCHTEMEYER",
        "first_name": "DEREK",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-23",
        "last_updated": "2013-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "002981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Craig Stone, MD
• Jessica Stouffer, MSW, LMSW
• Barry Neil Straus, M.D.
• Pamela Lynn Strickland, M.D.
• Strong Faith Medical Supply, LLC
• Stuart Loos DDD LLC
• Paola Juliana Suarez, M.D.
• Lavanya Subramanian, M.D.
• Subspecialty Imaging, LLC
• Brent H. Suddeth, CRNA

• Professional Counselor in Canton, GA
• Providers in Canton, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.