Jessica Frances Deroche, LLBSW
Individual provider Active NPI Social Worker · Kingsford, MI
NPI 1801544317 · NPPES record last updated Sep 28, 2022
Key facts
- NPI
- 1801544317
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 6802091292 (MI)
- Practice address
- 715 Pyle Dr
Kingsford, MI 49802-4456 - Phone
- (906) 239-9253
- Fax
- (906) 779-0645
- NPI assigned
- Mar 14, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6802091292 | MI | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802091292 | MI | Yes |
Addresses
Primary practice location
715 Pyle Dr
Kingsford, MI 49802-4456
Mailing address
715 Pyle Dr
Kingsford, MI 49802-4456
Phone (906) 239-9253
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6852091292 | Medicaid | MI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jderoche@nbhs.org | ||
| Direct Messaging Address | jderoche@nbhs.org | Health Information Exchange (HIE) |
Other providers in Kingsford, MI
- Community Substance Abuse Services, Inc.
- Community Substance Abuse Services, Inc.
- Corrina Chiropractic PLLC
- Robert Joseph D Amour
- Taya Dehling
- Rebecca Ann Dessellier
- Dickinson County Healthcare System
- Dickinson County Healthcare System
- Dickinson Neurology Associates P C
- Dickinson-Iron Intermediate School District
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.