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
Mailing address3205 N Academy Blvd Ste 130, Colorado Springs, CO 80917-5152

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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