Active NPI
Derek Coffey
- Mental Health Counselor
- Lincoln, NE
National Provider Identifier
1861052607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 11818
- Practice address
- 3201 Pioneers Blvd Ste 222
Lincoln, NE 68502-5963 - Phone
- (402) 413-7171
- Fax
- (844) 308-8875
- NPI assigned
- Jun 14, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 | 11818 | NE | Primary |
Addresses
Primary practice location
3201 Pioneers Blvd Ste 222
Lincoln, NE 68502-5963
Mailing address
5844 S 91St St
Lincoln, NE 68526-9540
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 |
|---|---|---|---|
| 11818 | NE | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560470400000",
"number": "1861052607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5844 S 91ST ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685269540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 PIONEERS BLVD STE 222",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685025963",
"telephone_number": "402-413-7171",
"fax_number": "844-308-8875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COFFEY",
"first_name": "DEREK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-14",
"last_updated": "2019-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "11818",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.