Innerlight, Inc.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

83 Issued in CO

Legal business name

INNERLIGHT, INC.

Practice address

8089 S Lincoln St
Suite 203
Littleton, CO 80122-2700

Phone

(303) 915-5567

NPI assigned

Feb 6, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Derica Waller, LCSWNPI 1033258769

Title

Owner and Psychotherapist

Phone

(303) 915-5567

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Derica Waller, LCSW

  • Clinical Social Worker
  • Littleton, CO
  • NPI 1033258769
  NPD (past) Authorized official

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396884011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8089 S LINCOLN ST",
            "address_2": "SUITE 203",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801222700",
            "telephone_number": "303-915-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8089 S LINCOLN ST",
            "address_2": "SUITE 203",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801222700",
            "telephone_number": "303-915-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNERLIGHT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "DERICA",
        "authorized_official_title_or_position": "OWNER AND PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "303-915-5567",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "83",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Littleton, CO
• Providers in Littleton, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.