Jeffrey David Derry, LPC in Fountain, CO - Medicare Counselor Provider

Jeffrey David Derry, LPC is a medicare enrolled "Counselor - Professional" provider in Fountain, Colorado. His current practice location is 350 Lyckman Pl, Fountain, Colorado. You can reach out to his office (for appointments etc.) via phone at (719) 632-5700.

Jeffrey David Derry is licensed to practice in Colorado (license number LPC.0003637) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1528359734.

Contact Information

	Jeffrey David Derry, LPC
	350 Lyckman Pl, Fountain, CO 80817-2861
	(719) 632-5700
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jeffrey David Derry
Gender	Male
Speciality	Counselor - Professional
Location	350 Lyckman Pl, Fountain, Colorado
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1528359734
Provider Enumeration Date: 04/21/2011
Last Update Date: 03/21/2018

Medicare PECOS Information:

PECOS PAC ID: 9335599307
Enrollment ID: I20240103002516

Medical Identifiers

Medical identifiers for Jeffrey David Derry such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1528359734	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	2009024349 (Missouri)	Secondary
101YP2500X	Counselor - Professional	LPC.0003637 (Colorado)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jeffrey David Derry allows following entities to bill medicare on his behalf.

Entity Name	Peak Vista Community Health Centers
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1730166034 PECOS PAC ID: 4688583974 Enrollment ID: O20031110000337

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jeffrey David Derry is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jeffrey David Derry, LPC 3205 N Academy Blvd Ste 130, Colorado Springs, CO 80917-5152 Ph: (719) 632-5700	Jeffrey David Derry, LPC 350 Lyckman Pl, Fountain, CO 80817-2861 Ph: (719) 632-5700

Reviews and Comments

Counselor in Fountain, CO

Martha Gadson, MSW, CAS Counselor Medicare: Not Enrolled in Medicare Practice Location: 210 W Ohio Ave, Fountain, CO 80817 Phone: 719-237-6535
Jennifer Bush, Counselor Medicare: Not Enrolled in Medicare Practice Location: 9790 Rolling G Rd, Fountain, CO 80817 Phone: 719-588-9174
John Henry Keilers, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 301 E Iowa Ave, Fountain, CO 80817 Phone: 719-572-6330 Fax: 719-572-6080
Melissa R Petrone, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5195 Fontaine Blvd, Fountain, CO 80817 Phone: 719-271-9022
Chelsea Staver, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 350 Lyckman Pl, Fountain, CO 80817 Phone: 719-522-6227
Mrs. Carolyn Roberta Wroten, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8158 Silver Glen Drive, Fountain, CO 80817 Phone: 719-382-8467
Dolores J Walker, MAC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 8317 Parkglen Dr, Fountain, CO 80817 Phone: 719-244-0350

Jeffrey David Derry, LPC - Medicare Counselor in Fountain, CO