Active NPI
Derek Anderson, LPC
- Professional Counselor
- Mesquite, TX
National Provider Identifier
1477181006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 88317
- Practice address
- 120 W Main St
Mesquite, TX 75149-4264 - Phone
- (214) 351-3490
- NPI assigned
- Mar 30, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 88317 | TX | Primary |
| Community Health Worker | 172V00000X |
Addresses
Primary practice location
120 W Main St
Mesquite, TX 75149-4264
Mailing address
500 Sunrise Cir
Seagoville, TX 75159-2043
Phone (903) 804-7441
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88317 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premierpoint Behavioral Health PLLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Rowlett, TX
- NPI 1649114653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730851200000",
"number": "1477181006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 SUNRISE CIR",
"city": "SEAGOVILLE",
"state": "TX",
"postal_code": "751592043",
"telephone_number": "903-804-7441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 W MAIN ST",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751494264",
"telephone_number": "214-351-3490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "DEREK",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-03-30",
"last_updated": "2024-11-06",
"certification_date": "2024-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "88317",
"primary": true
},
{
"code": "172V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesquite, TX
- Amigo Pediatrics PLLC
- Niloofar Amirpour
- Amity Home Health Care Services LLC
- An Abundance of Love Enterprises LLC
- Anderson Chiropractic Health and Wellness Mecca
- Michael Edwin Clayton Anderson, D.C.
- Paula Graves Anderson
- Steven R Anderson, D.C.
- Theresa Lorene Anderson, RDH
- Alycia Dawn Andersson, CRNA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.