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EMILY DERBY LMHC, LPC
NPI 1659766376
Counselor - Mental Health in Johnston, RI

Active since March 31, 2015PECOS EnrolledAccepts Medicare Assignment
1443 HARTFORD AVE, JOHNSTON, RI 02919(401) 273-8100 Get Directions Write a Review

NPPES record last updated: May 1, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Emily Derby Lmhc, Lpc NPPES

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

EMILY DERBY LMHC, LPC (NPI 1659766376) is an individual mental health provider in Johnston, Rhode Island, licensed in Rhode Island (MHC00693) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1659766376
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameEMILY DERBYCredential: LMHC, LPC
Location Address1443 HARTFORD AVEJohnston, RI 02919-3224
Mailing Address117 Ellenfield St Ste 101Providence, RI 02905-4541
Phone(401) 273-8100
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateMarch 31, 2015
Last NPPES UpdateMay 1, 2022
NPPES CertifiedMarch 2, 2022
✔ NPI 1659766376 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in RI · MHC00693
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License LPC.0016171 (CO)
1443 HARTFORD AVE, Johnston, RI 02919
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Emily Derby Lmhc, Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4688025059
PECOS Enrollment IDI20240110001861
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Emily Derby reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Gateway Healthcare Inc
7.6 mi
Mental Health (Including Community Mental Health Center)
101-103 BACON ST
Pawtucket, RI 02860
  • Reassigned Medicare billing, Rhode Island enrollment
  • 150 clinicians in this Medicare group
NPI 1821078932 (401) 722-3560

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

SANTANNA ROCHA J.D., M.S.W., LCSW
Social Worker (Clinical)
1443 HARTFORD AVE
JOHNSTON, RI 02919
Providence County (401) 273-8100
LAURIE THORNTON MA, CAGS, LMHC
Counselor
1443 HARTFORD AVE
JOHNSTON, RI 02919
Providence County (401) 273-8100
MIKAYLA KELMER MA
Counselor (Mental Health)
1443 HARTFORD AVE
JOHNSTON, RI 02919
Providence County (401) 273-8100
MCKAYLA ARBIGE MASTERS
Counselor (Mental Health)
1443 HARTFORD AVE
JOHNSTON, RI 02919
Providence County (401) 553-1000
CHERYL LEKHANA PEREJI MHC-A
Counselor (Mental Health)
1443 HARTFORD AVE
JOHNSTON, RI 02919
Providence County (401) 273-8100
VANNESSA SWINSON
Counselor
1443 HARTFORD AVE
JOHNSTON, RI 02919
Providence County (401) 273-8100
OMER CERMIK MD
Psychiatry & Neurology (Psychiatry)
1443 HARTFORD AVE
JOHNSTON, RI 02919
Providence County (401) 273-8100
ELLEN FITZGERALD-MCCALLUM LICSW
Social Worker (Clinical)
1443 HARTFORD AVE
JOHNSTON, RI 02919
Providence County (401) 273-8100

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 Emily Derby's NPI number?

The NPI number for Emily Derby is 1659766376. It was assigned to this individual provider in the NPPES registry on March 31, 2015.

Where is Emily Derby located?

Emily Derby practices at 1443 Hartford Ave, Johnston, RI 02919. The listed phone number is (401) 273-8100.

What is Emily Derby's specialty?

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

Is Emily Derby enrolled in Medicare?

Yes. Emily Derby is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Emily Derby's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Emily Derby reassigns Medicare benefits to Gateway Healthcare Inc (Pawtucket, RI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Emily Derby's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Emily Derby was last updated on May 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.