Active NPI
Nathanael Derose
- Mental Health Counselor
- Newport, RI
National Provider Identifier
1700795234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 513 Broadway
Newport, RI 02840-1471 - Phone
- (401) 324-9100
- NPI assigned
- Sep 2, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
513 Broadway
Newport, RI 02840-1471
Mailing address
6 Laflamme Ave
Woonsocket, RI 02895-6510
Other practice location 1
361 Newbury St Fl 5
Boston, MA 02115-2727
Phone (401) 324-9100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788307200000",
"number": "1700795234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 LAFLAMME AVE",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "513 BROADWAY",
"city": "NEWPORT",
"state": "RI",
"postal_code": "028401471",
"telephone_number": "401-324-9100"
}
],
"practiceLocations": [
{
"address_1": "361 Newbury St Fl 5",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021152727",
"country_code": "US",
"telephone_number": "401-324-9100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEROSE",
"first_name": "NATHANAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-09-02",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.