Individual provider Active NPI

Erika Desjardins

  • Mental Health Counselor
  • Philadelphia, PA
National Provider Identifier
1679966196
Registry record updated Mar 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4641 Roosevelt Blvd
Philadelphia, PA 19124-2343
Phone
(215) 305-6682
NPI assigned
Mar 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2015

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 Primary

Addresses

Primary practice location

4641 Roosevelt Blvd
Philadelphia, PA 19124-2343

Mailing address

8220 Castor Ave
Philadelphia, PA 19152-2729
Phone (215) 305-6682

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

NPI Registry JSON

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

{
    "created_epoch": "1425772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425772800000",
    "number": "1679966196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8220 CASTOR AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522729",
            "telephone_number": "215-305-6682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191242343",
            "telephone_number": "215-305-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESJARDINS",
        "first_name": "ERIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-08",
        "last_updated": "2015-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2015; 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.