Active NPI
Derek Edge
- Mental Health Counselor
- Manchester, NH
National Provider Identifier
1740556117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 834
- Practice address
- 555 Auburn St
Manchester, NH 03103-4803 - Phone
- (603) 623-8863
- NPI assigned
- Mar 29, 2012
- 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 | 834 | NH | Primary |
Addresses
Primary practice location
555 Auburn St
Manchester, NH 03103-4803
Mailing address
8 Washington CT
Center Barnstead, NH 03225-3331
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": "1332979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332979200000",
"number": "1740556117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 WASHINGTON CT",
"city": "CENTER BARNSTEAD",
"state": "NH",
"postal_code": "032253331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 AUBURN ST",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031034803",
"telephone_number": "603-623-8863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDGE",
"first_name": "DEREK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-03-29",
"last_updated": "2012-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NH",
"license": "834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.