Derick C Scovel, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY2484 Issued in WA

Practice address

10000 NE 7TH Ave Ste 215
Vancouver, WA 98685-4542

Phone

(360) 574-9565

Fax

(360) 574-9685

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Frederick C Scovel Former name

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Geromedical Psychological Service PSGroup PAC ID 9436180684, shared by 2 NPIs, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Geromedical Psychological Service PS

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1659482925
  Medicare reassignment NPD
• Geromedical Psychological Service PS

  • Clinical Psychologist
  • Portland, OR
  • NPI 1043501836
  Medicare reassignment NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1407967813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 MAIN ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602663",
            "telephone_number": "360-574-9565",
            "fax_number": "360-574-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 NE 7TH AVE STE 215",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986854542",
            "telephone_number": "360-574-9565",
            "fax_number": "360-574-9685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOVEL",
        "first_name": "DERICK",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2711",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY2484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8352320",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FREDERICK",
            "last_name": "SCOVEL",
            "middle_name": "C",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michele Shawn Scott, LMHC
• Ragnar W Scott, PMHNP
• Samantha Jean Scott
• Sierra Scott
• Tammy Mills Scott, RN
• Whitney Scribner, LMP
• Geppina Scrigna, LMP
• Jaime Jo Scurti
• Sea - Mar Community Health Center
• Sea Mar Community Health Centers

• Clinical Psychologist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.