Derick B Palmer, ED.D, LPC, LMHC, NCC
Individual provider Active NPI Professional Counselor · Kirtland Afb, NM
NPI 1396901757 · NPPES record last updated Feb 26, 2026
Key facts
- NPI
- 1396901757
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 713 (AK)
- Practice address
- 2050 A 2ND St SE
Kirtland Afb, NM 87117-5901 - Phone
- (505) 846-3200
- NPI assigned
- Aug 4, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AK, OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241022004846 | AK | Practitioner - Mental Health Counselor | 3274066774 | Reassigns benefits to 2 organizations |
| I20241022004987 | OR | Practitioner - Mental Health Counselor | 3274066774 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RC60018183 | WA | MD | Counselor |
| LH60210091 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sokyahealth Medical Group PC | Counselor | Current |
Accepting new patients |
| Achieve Medical Alaska LLC | Current |
Accepting new patients | |
| Valuecore Mental Health | Past | Accepting new patients |
Locations
1917 Abbott Rd
Ste 101
Anchorage, AK 99507
Phone (907) 440-4420
2741 Debarr Rd
Ste 411
Anchorage, AK 99508
Phone (907) 331-0140
700 NE Multnomah St
Ste 870
Portland, OR 97232
Phone (503) 238-5559
8555 SW Apple Way
Ste 320
Portland, OR 97225
Phone (503) 298-4592
Interoperability endpoints
- derick.palmer.p1@direct.sokya.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | RC60018183 | WA | |
| Mental Health Counselor | 101YM0800X | LH60210091 | WA | |
| Professional Counselor | 101YP2500X | 713 | AK | Yes |
Addresses
Primary practice location
2050 A 2ND St SE
Kirtland Afb, NM 87117-5901
Mailing address
9730 Highway 238
Jacksonville, OR 97530-9601
Phone (541) 841-8591
Other practice location 1
9730 Highway 238
Jacksonville, OR 97530-9601
Phone (541) 841-8591
Other providers in Kirtland Afb, NM
- Ronald Nelson
- Mark Noakes
- Lindsay Ortman
- Mary Ann Terese Orzech
- Lesley Dale Pacheco
- James Palmer
- Michael Jonathan Paston
- John Keith Paul III
- Daniel Pena
- Monica Pierce-Wysong
All providers in Kirtland Afb, NM · Professional Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.