Derik M Comperatore, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

SW133095 Issued in PA

Practice address

767 Scotch Valley Rd Ste 3a
Hollidaysburg, PA 16648-6601

Phone

(814) 934-1261

NPI assigned

Jan 5, 2016

Last updated

Aug 19, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1609232735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 CONEMAUGH AVE",
            "city": "PORTAGE",
            "state": "PA",
            "postal_code": "159461728",
            "telephone_number": "814-515-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 SCOTCH VALLEY RD STE 3A",
            "city": "HOLLIDAYSBURG",
            "state": "PA",
            "postal_code": "166486601",
            "telephone_number": "814-934-1261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 Valley View Blvd",
            "address_purpose": "LOCATION",
            "city": "Altoona",
            "state": "PA",
            "postal_code": "166026080",
            "country_code": "US",
            "telephone_number": "814-944-9970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COMPERATORE",
        "first_name": "DERIK",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-05",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW133095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Hollidaysburg, PA
• Providers in Hollidaysburg, PA by specialty
• Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.