Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.
MR. DEREK TODD LOFGREEN LPC
NPI 1881688919
Counselor - Professional in Mesa, AZ
Active since September 05, 2005
About Mr. Derek Todd Lofgreen Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. DEREK TODD LOFGREEN LPC (NPI 1881688919) is an individual professional provider in Mesa, Arizona, licensed in Arizona (LPC-1154) and active in the NPI registry since September 2005.
NPPES Registry Identity
NPI1881688919
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. DEREK TODD LOFGREENCredential: LPC
Location Address2650 E SOUTHERN AVEMesa, AZ 85204-5413
Mailing Address1454 N Rose CirMesa, AZ 85213-4016 · (602) 779-4325 · Fax (480) 926-8985
Phone(602) 779-4325
Fax(480) 926-8985
Sole ProprietorNo
Enumeration DateSeptember 5, 2005
Last NPPES UpdateJuly 13, 20263 updates tracked since enumeration
✔ NPI 1881688919 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in AZ · LPC-1154
2650 E SOUTHERN AVE, Mesa, AZ 85204
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1881688919, enumerated as an "individual" on September 05, 2005.
The provider is located at 2650 E SOUTHERN AVE MESA, AZ 85204 and the phone number is (602) 779-4325.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
