DERECK DAVID ESTRADA LPMHC NPI 1619440104

NPI Information

NPI: 1619440104
Provider Name: DERECK DAVID ESTRADA, LPMHC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
8495 CRATER LAKE HWY # 116B
WHITE CITY, OR
ZIP 97503
Phone: (541) 826-2111
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Dereck David Estrada, LPMHC is a mental health counselor in White City, OR. Dereck David Estrada, LPMHC NPI is 1619440104. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8495 CRATER LAKE HWY # 116B
WHITE CITY, OR
ZIP 97503-011
Phone: (541) 826-2111

The enumeration date for this NPI number is 1/7/2019 and was last updated on 1/7/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	C4199	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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