MR. GREGORY ALEXANDER DERDERIAN (NPI# 1942521224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942521224 |
| Entity Type | Individual |
| Full Name | MR. GREGORY ALEXANDER DERDERIAN |
| Credential | LMFT |
| Practice Address |
5280 34th St Lubbock TX 79407-1109 |
| Practice Telephone | 0637074358 |
| Mailing Telephone | 0637074358 |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2018-04-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 201464 | TX | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457355737 | Gregory Paul Derderian | Surgery | 538 N Old Woodward Ave, Birmingham, MI 48009-5375 | 2005-06-02 |
| Street Address |
5280 34TH ST |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79407-1109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033295514 | Cherry Dent Eaton | Home Health | 5280 34th St, Lubbock, TX 79407-3524 | 2006-10-27 |
| 1164574877 | Cherry Tree Health Services, Inc | Home Health | 5280 34th St, Lubbock, TX 79407-3524 | 2007-01-16 |
| 1285704007 | Agnes Dent | Home Health | 5280 34th St, Lubbock, TX 79407-3524 | 2006-11-09 |
| 1184700668 | Agnes B. Dent | Home Health | 5280 34th St, Lubbock, TX 79407-3524 | 2006-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275155731 | Bryce Olson Pt, LLC | Physical Therapist | 6014 45th St Ste C Lubbock, Tx 79407, 6014 45th St Ste C Lubbock, Tx 79407, Lubbock, TX 79407 | 2020-05-07 |
| 1235762923 | Fnu Sindhuja Gunasekaran | Physical Therapist | 6014 45th Street, Lubbock, TX 79407 | 2020-02-20 |
| 1770987554 | Amanda Moore | Occupational Therapist | 6548 43rd St, Lubbock, TX 79407 | 2014-10-22 |
| 1336565639 | Best Eye Visioncare, Pllc | Optometrist | 6020 34th Street, Lubbock, TX 79407 | 2014-03-11 |
| 1003249210 | Costco Wholesale Corporation | Pharmacy | 6020 34th St, Lubbock, TX 79407 | 2013-08-12 |
| 1225304686 | Community Health Center of Lubbock, Inc. | Clinic/Center | 5424 19th St Ste 200, Lubbock, TX 79407 | 2012-03-29 |
| 1023385879 | Medway Medical Equipment IIi LLC | Durable Medical Equipment & Medical Supplies | 3448 W Loop 289, Lubbock, TX 79407 | 2011-11-22 |
| 1801102553 | Jennifer Hobbs Williams | Nurse Practitioner | 1910 Quaker Ave Ste 101, Lubbock, TX 79407 | 2010-08-19 |
| 1780901496 | Joni Rodriguez | Counselor | 1611 Ave K, Lubbock, TX 79407 | 2010-04-21 |
| 1073776860 | Southwest Regional PCr, LLC | Clinical Medical Laboratory | 2002 W Loop 289 Ste 116, Lubbock, TX 79407 | 2008-07-02 |
| Find all providers in zip 79407 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851915326 | Mazie Zielinski | Marriage & Family Therapist | 9305 Utica Dr, Lubbock, TX 79424-4821 | 2020-06-01 |
| 1871128066 | Claire Eggleston | Marriage & Family Therapist | 6963 22nd Pl, Lubbock, TX 79407-1313 | 2020-03-08 |
| 1962045682 | Alex Theobald | Marriage & Family Therapist | 165 Human Sciences Building, Akron St., Lubbock, TX 79409-7940 | 2019-10-25 |
| 1316420102 | Neli Morris | Marriage & Family Therapist | 8212 Ithaca Ave Ste E7c, Lubbock, TX 79423-2633 | 2018-09-08 |
| 1306328927 | Jaclyn Danielle Cravens Pickens | Marriage & Family Therapist | 8212 Ithaca Ave Ste E12, Lubbock, TX 79423-2615 | 2018-08-30 |
| 1760904437 | Lynn Whitfield | Marriage & Family Therapist | 4913 S Loop 289 Ste 100, Lubbock, TX 79424-1630 | 2017-07-13 |
| 1427585728 | Cynthia Dsauza | Marriage & Family Therapist | 4010 82nd St Ste 105, Lubbock, TX 79423-1956 | 2017-05-17 |
| 1144681966 | Randy Porter | Marriage & Family Therapist | 1924 Broadway, Lubbock, TX 79401-3018 | 2016-03-08 |
| 1861882219 | Sterling Shumway | Marriage & Family Therapist | 9103 Huron Ave, Lubbock, TX 79424-7841 | 2015-01-23 |
| 1780967943 | Kimberly Ann Kerksiek | Marriage & Family Therapist | 7606 University Ave, Suite B-3, Lubbock, TX 79423-2155 | 2011-09-23 |
| Find all providers in LUBBOCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.