DERRICK LOREN SAMPSON MS SUDT MHP NPI 1679040901

NPI Information

NPI: 1679040901
Provider Name: DERRICK LOREN SAMPSON, MS, SUDT, MHP
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
12201 PACIFIC AVE S
TACOMA, WA
ZIP 98444
Phone: (253) 536-6425
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Derrick Loren Sampson, MS, SUDT, MHP is an addiction (substance use disorder) counselor in Tacoma, WA. Derrick Loren Sampson, MS, SUDT, MHP NPI is 1679040901. 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:

12201 PACIFIC AVE S
TACOMA, WA
ZIP 98444-126
Phone: (253) 536-6425

The enumeration date for this NPI number is 10/24/2018 and was last updated on 11/8/2019.

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	101YA0400X	Counselor	Addiction (Substance Use Disorder)	CO60749434	WASHINGTON	Yes
2	101YM0800X	Counselor	Mental Health	CG60832062	WASHINGTON	No

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: 4/28/2024

NPI Synchronization or Removal

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