Derrel Jeffrey, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

35597 Issued in TX

Practice address

345 Owen LN Ste 122
Waco, TX 76710-5583

Phone

(254) 218-2389

Fax

(855) 396-2470

NPI assigned

Nov 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Connection to Recovery, LLC

  • Mental Health Counselor
  • China Spring, TX
  • NPI 1598317042

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596844800000",
    "number": "1497827836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4906 LAKE ENGLEWOOD DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767102938",
            "telephone_number": "254-218-2389",
            "fax_number": "855-396-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 OWEN LN STE 122",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767105583",
            "telephone_number": "254-218-2389",
            "fax_number": "855-396-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFREY",
        "first_name": "DERREL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-08",
        "certification_date": "2020-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "35597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178626101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney B Jasso, AA
• Jayesh S. Patel, DDS, PA
• Jeff Bauer, D.D.S., PLLC
• Jennifer Jefferson, LCSW
• Jeffrey T Manning MD PA
• Patrick M Jenkins, CRNA
• Corey Jensen, LCSW
• Randall D. Jensen, M.D.
• Meredith McCoy Jergins, PA-C
• Floyd Edsil Jernigan, M.D.

• Clinical Social Worker in Waco, TX
• Providers in Waco, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.