Derry, Jeffrey David

Derry, Jeffrey David is an individual health care provider with primary practice located at 350 Lyckman Pl , Fountain CO 80817-2861. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Derry, Jeffrey David can be contacted via phone (719) 632-5700.

Contact Information

Primary practice address
350 Lyckman Pl Fountain CO 80817-2861
Phone: (719) 632-5700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 2009024349 Missouri
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC.0003637 Colorado

Profile Details

NPI number 1528359734
LBN Legal business name Derry, Jeffrey David
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2011
Last updated Mar 21st, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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