Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Derek Marrongelle, DACM, LAC, CCN

Individual provider Acupuncturist · NPI 1417581539

Derek Marrongelle, DACM, LAC, CCN is an Acupuncturist in Phoenix, Arizona. Works from 2 locations. Licensed in Arizona.

Licensed in
AZ
In the registry since
2020
Specialties on file
2
What do these letters mean?
LAC — Licensed Associate Counselor
A counsellor practising under supervision toward full licensure. In some states the same letters mean Licensed Acupuncturist.

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Practice location Address checks out

16421 N Tatum Blvd Ste 210
Phoenix, AZ 85032-3457
Phone: (570) 617-9005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 113 Pine Creek Dr, Orwigsburg, PA 17961-9135 — (570) 617-9005

Specialties & licences

Acupuncturist (primary) Taxonomy 171100000X · Licence LAC-010133 (AZ)
Nutritionist Taxonomy 133N00000X · Licence 5063

Record details

NPI number1417581539
Entity typeIndividual (Type 1)
GenderMale
Credentials DACM , LAC , CCN
Sole proprietorNo
NPI enumeratedFebruary 27, 2020
Last updated in NPPESAugust 25, 2020
Certification dateAugust 25, 2020

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