National Provider Identifier

Peggy S. Derivan, MS, LMHC

Peggy S. Derivan, MS, LMHC is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Rochester, NY and a listed phone number of (585) 766-3082.

NPI 1073797833Rochester, NYMental Health Counselor

Profile Overview

NPI
1073797833
Provider Type
Individual
Primary Specialty
Mental Health Counselor
Enumeration Date
December 28, 2007
Last Updated
November 02, 2017

Practice Location

  • 590 Titus Ave
  • Rochester, NY 14617

Phone: (585) 766-3082

Specialties

  • Mental Health Counselor (101YM0800X)
Full Record
NPI
1073797833
Entity Type
Individual
Last Name
Derivan
First Name
Peggy
Middle Name
S.
Name Prefix
MS.
Credential
MS, LMHC
Provider Other Last Name
Gold
Provider Other First Name
Peggy
Provider Other Middle Name
S
Provider Other Credential Text
MS, LMHC
Provider Other Last Name Type Code
5
Mailing Street Address
590 Titus Ave
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14617
Mailing Country
US
Mailing Phone
(585) 766-3082
Mailing Fax
(585) 266-9336
Practice Street Address
590 Titus Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14617
Practice Country
US
Practice Phone
(585) 766-3082
Enumeration Date
December 28, 2007
Last Updated
November 02, 2017
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Mental Health Counselor (101YM0800X)