Active NPI
Melissa Deroos, CADC
- Addiction (Substance Use Disorder) Counselor
- Sioux City, IA
National Provider Identifier
1740642255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 14114
- Practice address
- 2309 Jackson St
Sioux City, IA 51104-3546 - Phone
- (712) 258-5424
- Fax
- (712) 224-3722
- NPI assigned
- Mar 23, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 14114 | IA | Primary |
Addresses
Primary practice location
2309 Jackson St
Sioux City, IA 51104-3546
Mailing address
2309 Jackson St
Sioux City, IA 51104-3546
Phone (712) 258-5424
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14114 | IA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458691200000",
"number": "1740642255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2309 JACKSON ST",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511043546",
"telephone_number": "712-258-5424",
"fax_number": "712-224-3722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2309 JACKSON ST",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511043546",
"telephone_number": "712-258-5424",
"fax_number": "712-224-3722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEROOS",
"first_name": "MELISSA",
"credential": "CADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-23",
"last_updated": "2016-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IA",
"license": "14114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.