Individual provider Active NPI

Brigid Teresa Deperro

  • Mental Health Counselor
  • Bronx, NY
National Provider Identifier
1548025174
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
18-P119254-01 Issued in NY
Practice address
509 Willis Ave FL 4a
Bronx, NY 10455-4001
Phone
(347) 862-2034
NPI assigned
Feb 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 18-P119254-01 NY Primary

Addresses

Primary practice location

509 Willis Ave FL 4a
Bronx, NY 10455-4001

Mailing address

509 Willis Ave FL 4a
Bronx, NY 10455-4001
Phone (347) 862-2034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18-P119254-01NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Luminous Mental Health Counseling Mental Health CurrentSince Feb 18, 2024 Accepting new patients

Locations

509 Willis Ave
Fl 4A
Bronx, NY 10455
Phone (347) 734-6000

930 Grand Concourse
Apt 1F
Bronx, NY 10451
Phone (347) 862-2034

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.

NPI Registry JSON

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1548025174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 WILLIS AVE FL 4A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104554001",
            "telephone_number": "347-862-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 WILLIS AVE FL 4A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104554001",
            "telephone_number": "347-862-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPERRO",
        "first_name": "BRIGID",
        "middle_name": "TERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-13",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "18-P119254-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.