Shockie Dersno, LPC
NPI 1154961464 · Mental Health Counselor · Phoenix, AZ
Enrolled with Medicare as Practitioner - Mental Health Counselor · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Shockie Dersno, LPC is a Mental Health Counselor provider in Phoenix, AZ (NPI 1154961464).
Provider details
- NPI number
- 1154961464
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- No
- License
- 18672 (AZ)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2020-01-14
- Last updated
- 2025-07-01
- Certified
- 2025-07-01
Frequently asked questions
- What is Shockie Dersno's NPI number?
- Shockie Dersno's National Provider Identifier (NPI) is 1154961464, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Shockie Dersno's specialty?
- Shockie Dersno is listed in the NPPES registry with a primary specialty of Mental Health Counselor (Behavioral Health & Social Service Providers).
- Where is Shockie Dersno located?
- Shockie Dersno's practice location on file with NPPES is 1840 N 95th Ave Ste 146, Phoenix, AZ 85037-4446.
- What is Shockie Dersno's phone number?
- The practice phone number listed in the NPPES registry for Shockie Dersno is (404) 953-2501.
- Does Shockie Dersno accept Medicare?
- Shockie Dersno is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Shockie Dersno's NPI active?
- Yes — Shockie Dersno's NPI (1154961464) is active in the NPPES registry as of the last update on 2025-07-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.