Provider Demographics
NPI:1982826020
Name:HOPSON, DEREK STEVEN SR (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:STEVEN
Last Name:HOPSON
Suffix:SR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 TIME SQUARE AVE
Mailing Address - Street 2:#234
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-7500
Mailing Address - Country:US
Mailing Address - Phone:860-857-4121
Mailing Address - Fax:
Practice Address - Street 1:6400 TIME SQUARE AVE
Practice Address - Street 2:#234
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-7500
Practice Address - Country:US
Practice Address - Phone:860-857-4121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7409103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist