Deanna Derry Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

DEANNA DERRY COUNSELING LLC

Practice address

4656 W Jefferson Blvd Ste 285
Fort Wayne, IN 46804-6838

Phone

(260) 422-9372

Fax

(260) 422-0843

NPI assigned

Sep 8, 2023

Organization subpart

No

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

Authorized official

Name

Deanna DerryNPI 1639955263

Title

Owner

Phone

(260) 312-0171

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Deanna Derry, LCSW

  • Clinical Social Worker
  • Fort Wayne, IN
  • NPI 1639955263
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694131200000",
    "number": "1992581524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4656 W JEFFERSON BLVD STE 285",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046838",
            "telephone_number": "260-422-9372",
            "fax_number": "260-422-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4656 W JEFFERSON BLVD STE 285",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046838",
            "telephone_number": "260-422-9372",
            "fax_number": "260-422-0843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEANNA DERRY COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-08",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A",
        "authorized_official_last_name": "DERRY",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-312-0171"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dean Ullrich Acsw LCSW PC
• Joanne Dean
• Josie J Dean, NP
• Kyrea Dean
• Matthew William Dean
• Cendra Deardorf
• Ciersten A Deardorf, MS, RDN, CD
• Georges Debal
• Joellen Decamp
• Joseph Richard Decamp, MD

• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.