Derrico Wylie, PHD, LCPC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

5713 Linda LN
Camp Springs, MD 20748-2331

Phone

(615) 300-7092

NPI assigned

Mar 1, 2007

Sex

Male

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

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573948800000",
    "number": "1700914801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5713 LINDA LN",
            "city": "CAMP SPRINGS",
            "state": "MD",
            "postal_code": "207482331",
            "telephone_number": "615-300-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5713 LINDA LN",
            "city": "CAMP SPRINGS",
            "state": "MD",
            "postal_code": "207482331",
            "telephone_number": "615-300-7092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "633 Thompson Ln",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372043616",
            "country_code": "US",
            "telephone_number": "615-460-4462",
            "fax_number": "615-460-4431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "DERRICO",
        "name_prefix": "Dr.",
        "credential": "PHD, LCPC, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2019-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Camp Springs, MD
• Providers in Camp Springs, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2019; 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.