MR. PETER W. DEROSA LPC NPI 1881924652

NPI Information

  • NPI: 1881924652
  • Provider Name: MR. PETER W. DEROSA, LPC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • Address: 20 MAPLE AVE
    UNCASVILLE, CT
    ZIP 06382
  • Phone: (860) 848-3098

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NPI Details

MR. Peter W. Derosa, LPC is a professional counselor in Uncasville, CT. MR. Peter W. Derosa, LPC NPI is 1881924652. 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:

20 MAPLE AVE
UNCASVILLE, CT
ZIP 06382-345
Phone: (860) 848-3098
Fax: (860) 848-1152

The enumeration date for this NPI number is 12/30/2009 and was last updated on 12/30/2009.

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
1101YP2500XCounselorProfessional976CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1060966963MEDICAIDCONNECTICUT

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: 11/21/2025

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