Katie Derkacz, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101008382 Issued in MI

Practice address

6777 W Maple Rd
Speech Language Pathology Department
West Bloomfield, MI 48322-3013

Phone

(248) 661-7241

Fax

(248) 325-0074

NPI assigned

Feb 19, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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": "1739923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1699570903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6777 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223013",
            "telephone_number": "248-661-7241",
            "fax_number": "248-325-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6777 W MAPLE RD",
            "address_2": "SPEECH LANGUAGE PATHOLOGY DEPARTMENT",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223013",
            "telephone_number": "248-661-7241",
            "fax_number": "248-325-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERKACZ",
        "first_name": "KATIE",
        "name_prefix": "Miss",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101008382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental Care of Michigan
• Dental House - West Bloomfield
• Brian Patrick Denton, M.D.
• Devyn Depeter, RBT
• Rebecca Sue Deraud, MSW
• Amy Philomena Derosa, D.O.
• Piyush K. Desai, M.D.
• Lindsey Desana
• Jeffrey Thomas Desano II, D.O.
• Marjorie Gail Deschner, OTR/L

• Speech-Language Pathologist in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Speech-Language Pathologist in Michigan

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