Derrick Thomas Yeager, LAPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

1102-1-1-21A Issued in ND

Practice address

3535 S 31St St Ste 201
Grand Forks, ND 58201-3593

Phone

(701) 780-6821

Fax

(701) 780-1973

NPI assigned

Oct 21, 2021

Sex

Male

Sole proprietor

Yes

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

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

University of North Dakota School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Assessment and Therapy Associates of Grand Forks PLLCGroup PAC ID 9436152626, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Assessment and Therapy Associates of Grand Forks, PLLC

  • Clinical Psychologist
  • Grand Forks, ND
  • NPI 1437181591
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1972266401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 S 31ST ST STE 201",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013593",
            "telephone_number": "701-780-6821",
            "fax_number": "701-780-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 S 31ST ST STE 201",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013593",
            "telephone_number": "701-780-6821",
            "fax_number": "701-780-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEAGER",
        "first_name": "DERRICK",
        "middle_name": "THOMAS",
        "credential": "LAPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-21",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ND",
            "license": "1102-1-1-21A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josie Lynn Wutzke
• Jenifer Wynne, APRN, GNP-BC
• Anne L Wysocki, MA CCC-SLP
• Yan Xiang Xia, MD
• Catherine Yeager, PHD
• Natasha Angeline Yearwood, MT-BC
• Jody Yeh-Shinbrood, LCSW
• Michael August Yeradi
• Glen Y Yoshida, MD
• You & Eye Eyewear LLC

• Counselor in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.