Active NPI
Christina Marie Derrick, LMFT
- Marriage & Family Therapist
- Camden, SC
National Provider Identifier
1245584481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 4152
- Practice address
- 813 John G Richards Rd
Camden, SC 29020-9484 - Phone
- (803) 312-5585
- NPI assigned
- Nov 8, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 4152 | SC | Primary |
Addresses
Primary practice location
813 John G Richards Rd
Camden, SC 29020-9484
Mailing address
813 John G Richards Rd
Camden, SC 29020-9484
Phone (803) 312-5585
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 |
|---|---|---|---|
| 4152 | SC | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352332800000",
"number": "1245584481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "813 JOHN G RICHARDS RD",
"city": "CAMDEN",
"state": "SC",
"postal_code": "290209484",
"telephone_number": "803-312-5585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "813 JOHN G RICHARDS RD",
"city": "CAMDEN",
"state": "SC",
"postal_code": "290209484",
"telephone_number": "803-312-5585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERRICK",
"first_name": "CHRISTINA",
"middle_name": "MARIE",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-08",
"last_updated": "2012-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "SC",
"license": "4152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camden, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.