Derek Jason Trlica, MA, RC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

RC00036223 Issued in WA

Practice address

16150 NE 85TH St Ste 222
Family Services
Redmond, WA 98052-3546

Phone

(425) 869-6687

Fax

(877) 880-4388

NPI assigned

Jan 19, 2007

Last updated

Apr 22, 2008By the provider in NPPES

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

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wellspring Family Services

  dba Wellspring

  • Case Management Agency
  • Seattle, WA
  • NPI 1093740573
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1780737148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16150 NE 85TH ST STE 222",
            "address_2": "FAMILY SERVICES",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523546",
            "telephone_number": "425-869-6687",
            "fax_number": "877-880-4388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16150 NE 85TH ST STE 222",
            "address_2": "FAMILY SERVICES",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523546",
            "telephone_number": "425-869-6687",
            "fax_number": "877-880-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRLICA",
        "first_name": "DEREK",
        "middle_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "MA, RC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "RC00036223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Redmond, WA
• Providers in Redmond, WA by specialty
• Professional Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.