Derick Bugg, NCC
Individual provider Active NPI Mental Health Counselor · Umatilla, FL
NPI 1629564976 · NPPES record last updated Jul 10, 2018
Key facts
- NPI
- 1629564976
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 19201 Twin Ponds Rd
Umatilla, FL 32784-9220 - Phone
- (480) 747-5168
- NPI assigned
- Jul 10, 2018
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
19201 Twin Ponds Rd
Umatilla, FL 32784-9220
Mailing address
19201 Twin Ponds Rd
Umatilla, FL 32784-9220
Phone (480) 747-5168
Other providers in Umatilla, FL
- Kathleen Bastone
- Justin Beyer
- Jeffrey Stephen Boyd
- Celesta Dawn Brosowsky
- Lea Ann Buffenbarger
- Morgan Byrd
- Gustavo A Castillo
- Vickie Sue Chapman
- Clark Transport LLC
- Cornerstone Family Health Care, Inc
All providers in Umatilla, FL · Mental Health Counselor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.