Individual provider Active NPI

Derek Moniz, LCDP

  • Addiction (Substance Use Disorder) Counselor
  • Woonsocket, RI
National Provider Identifier
1346066966
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDP01014 Issued in RI
Practice address
800 Clinton St
Woonsocket, RI 02895-3245
Phone
(401) 445-4111
Fax
(401) 767-9177
NPI assigned
Nov 27, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDP01014 RI Primary

Addresses

Primary practice location

800 Clinton St
Woonsocket, RI 02895-3245

Mailing address

PO Box 1700
Woonsocket, RI 02895-0856
Phone (401) 235-7000

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

LicenseStateTypeSpecialty
CDP01014RIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1732665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1346066966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1700",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028950856",
            "telephone_number": "401-235-7000",
            "fax_number": "401-767-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 CLINTON ST",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953245",
            "telephone_number": "401-445-4111",
            "fax_number": "401-767-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONIZ",
        "first_name": "DEREK",
        "credential": "LCDP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "RI",
            "license": "CDP01014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.