Derek H Elder LPC PLLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

63638 Issued in TX

Legal business name

DEREK H ELDER LPC PLLC

Practice address

16607 Blanco Rd Ste 502
San Antonio, TX 78232-1910

Phone

(210) 326-4663

Fax

(210) 428-6454

NPI assigned

Feb 1, 2018

Last updated

Feb 1, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Derek Hartley Elder, LPCNPI 1447540968

Title

Counselor

Phone

(210) 326-4663

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Derek Hartley Elder, LPC

  • Professional Counselor
  • San Antonio, TX
  • NPI 1447540968
  NPD Authorized official

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517443200000",
    "number": "1912405242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16607 BLANCO RD STE 502",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321910",
            "telephone_number": "210-326-4663",
            "fax_number": "210-428-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16607 BLANCO RD STE 502",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321910",
            "telephone_number": "210-326-4663",
            "fax_number": "210-428-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK H ELDER LPC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-02-01",
        "status": "A",
        "authorized_official_last_name": "ELDER",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "HARTLEY",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "210-326-4663",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "TX",
            "license": "63638",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "TX",
            "license": "63638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281324801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dept of Vertans Affairs
• Jarred Deptawa, M.A., BCBA, LBA
• Jane Louise Derby, RNC,MSN, CPNP, NNP
• Stephen Derdak, D.O.
• Lindsey Rausch Dereadt, CCC-SLP
• Valerie Deremer, PA
• Anthony Derencius, PA-C
• Tulamarie Alexies Derencius, P.A.
• Mohamed Derhab, MD
• Rob Ert Parris Derington, LAT

• Adolescent and Children Mental Health Clinic/Center in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Adolescent and Children Mental Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; 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.