Jay F Derosa, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC.0019830 Issued in CO

Practice address

179 S Parkside Dr
Colorado Springs, CO 80910-3130

Phone

(719) 572-6100

NPI assigned

Sep 28, 2023

Sex

Male

Sole proprietor

No

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 CO

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

Credentials

Master of Arts

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.

• Heart Centered Counseling, PC

  dba LifeStance Health

  • Mental Health Counselor
  • Fort Collins, CO
  • NPI 1588038681
  Medicare reassignment NPD
• Heart Centered Counseling, PC

  dba LifeStance Health

  • Mental Health Counselor
  • Colorado Springs, CO
  • NPI 1558158584
  NPD
• Heart Centered Counseling, PC

  dba LifeStance Health

  • Mental Health Counselor
  • Fort Collins, CO
  • NPI 1710577606
  NPD

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1396524245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 JET WING DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809162332",
            "telephone_number": "719-572-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 S PARKSIDE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103130",
            "telephone_number": "719-572-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSA",
        "first_name": "JAY",
        "middle_name": "F",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0019830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Dering, DNP, FNP-C, WHNP
• Jon Eric Derksen, M.D.
• Leah Derksen, NP
• Dermatology Clinic, P.C.
• Susan Gabrielle Dern, DO
• Jenna Derosier, RBT
• Doreen Ann Deross, MS, LPC, CACIII
• Kaylee Marie Derra, FNP-BC
• Alexander Derrickson
• Kimberly Savannah Derungs

• Professional Counselor in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.