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SHANNON DERICO
NPI 1548675739
Counselor - Mental Health in Gary, IN

Active since June 25, 2014
1100 W 6TH AVE, GARY, IN 46402(219) 885-4264(219) 888-9408 Get Directions Write a Review

NPPES record last updated: June 25, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shannon Derico NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON DERICO (NPI 1548675739) is an individual mental health provider in Gary, Indiana and active in the NPI registry since June 2014.

NPPES Registry Identity

NPI1548675739
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameSHANNON DERICO
Location Address1100 W 6TH AVEGary, IN 46402-1711
Mailing Address1100 W 6th AveGary, IN 46402-1711 · (219) 885-4264 · Fax (219) 888-9408
Phone(219) 885-4264
Fax(219) 888-9408
Sole ProprietorNo
Enumeration DateJune 25, 2014
✔ NPI 1548675739 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
1100 W 6TH AVE, Gary, IN 46402
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. LARESSE HARRIS APRN, FNP-C
Nurse Practitioner (Family)
1100 W 6TH AVE
GARY, IN 46402
Lake County (219) 885-4264
DAWN RANDLE
Behavior Technician
1100 W 6TH AVE
GARY, IN 46402
Lake County (219) 885-4264
RESEDA STURDIVANT
Technician, Other
1100 W 6TH AVE
GARY, IN 46402
Lake County (219) 885-4264
LYTINA NICOLE BARNETT
Social Worker
1100 W 6TH AVE
GARY, IN 46402
Lake County (219) 885-4264
JEWEL YVETTA JONES
Technician (Attendant Care Provider)
1100 W 6TH AVE
GARY, IN 46402
Lake County (219) 885-4264
DIANEA' LYNN MCINTOSH
Behavior Analyst
1100 W 6TH AVE
GARY, IN 46402
Lake County (219) 885-4264
MARSHA CLARK RN
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
1100 W 6TH AVE
GARY, IN 46402
Lake County (219) 240-8615
SHANELL LITHRESE HIGHTOWER
Counselor
1100 W 6TH AVE
GARY, IN 46402
Lake County (219) 885-4264

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Derico's NPI number?

The NPI number for Shannon Derico is 1548675739. It was assigned to this individual provider in the NPPES registry on June 25, 2014.

Where is Shannon Derico located?

Shannon Derico practices at 1100 W 6th Ave, Gary, IN 46402. The listed phone number is (219) 885-4264.

What is Shannon Derico's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Shannon Derico was last updated on June 25, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.