Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jeffrey David Derry, LPC

Individual provider Mental Health Counselor · NPI 1528359734

Jeffrey David Derry, LPC is a Mental Health Counselor in Fountain, Colorado. Qualified in 1999, 27 years ago. Practices with Peak Vista Community Health Centers, a 127-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Colorado and Missouri.

Years since qualifying
27
Licensed in
CO, MO
In the registry since
2011
Specialties on file
2
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

350 Lyckman Pl
Fountain, CO 80817-2861
Phone: (719) 632-5700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2935 Bagnell Dam Blvd, Lake Ozark, MO 65049-8661 — (573) 202-3740

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LPC.0003637 (CO)
Mental Health Counselor Taxonomy 101YM0800X · Licence 2009024349 (MO)

Record details

NPI number1528359734
Entity typeIndividual (Type 1)
GenderMale
Credentials LPC
Sole proprietorNo
NPI enumeratedApril 21, 2011
Last updated in NPPESMarch 21, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Peak Vista Community Health Centers — 127 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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