Active NPI
Bridget Teal Derkash, LPC, LAC
- Professional Counselor
- Basalt, CO
National Provider Identifier
1285428532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC.0014689
- Practice address
- PO Box 1115
Basalt, CO 81621-1115 - Phone
- (970) 924-0703
- NPI assigned
- Apr 9, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | ACD.0001797 | CO | |
| Professional Counselor | 101YP2500X | LPC.0014689 | CO | Primary |
Addresses
Primary practice location
PO Box 1115
Basalt, CO 81621-1115
Mailing address
PO Box 1115
Basalt, CO 81621-1115
Phone (970) 924-0703
Other names 1
- Bridget Teal Jankovsky
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 |
|---|---|---|---|
| ACD.0001797 | CO | MD | Addiction (Substance Use Disorder) Counselor |
| LPC.0014689 | CO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744156800000",
"number": "1285428532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1115",
"city": "BASALT",
"state": "CO",
"postal_code": "816211115",
"telephone_number": "970-924-0703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 1115",
"city": "BASALT",
"state": "CO",
"postal_code": "816211115",
"telephone_number": "970-924-0703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERKASH",
"first_name": "BRIDGET",
"middle_name": "TEAL",
"credential": "LPC, LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-09",
"last_updated": "2025-04-09",
"certification_date": "2025-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CO",
"license": "ACD.0001797",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "LPC.0014689",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BRIDGET",
"last_name": "JANKOVSKY",
"middle_name": "TEAL",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Basalt, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.