Active NPI
Derrick C Kiser
- Mental Health Counselor
- Easthampton, MA
National Provider Identifier
1881930758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 203 East St
Easthampton, MA 01027-1234 - Phone
- (774) 823-5744
- NPI assigned
- Dec 21, 2012
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary | ||
| Professional Counselor | 101YP2500X | |||
| School Counselor | 101YS0200X | |||
| Child & Adolescent Psychiatry Physician | 2084P0804X | S56441418 | MA |
Addresses
Primary practice location
203 East St
Easthampton, MA 01027-1234
Mailing address
203 East St
Easthampton, MA 01027-1234
Phone (774) 823-5744
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 |
|---|---|---|---|
| S56441418 | MA | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356048000000",
"number": "1881930758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "203 EAST ST",
"city": "EASTHAMPTON",
"state": "MA",
"postal_code": "010271234",
"telephone_number": "774-823-5744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 EAST ST",
"city": "EASTHAMPTON",
"state": "MA",
"postal_code": "010271234",
"telephone_number": "774-823-5744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISER",
"first_name": "DERRICK",
"middle_name": "C",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-12-21",
"last_updated": "2012-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MA",
"license": "S56441418",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Easthampton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.