Dale Pickett III, MS, NCC
Individual provider Active NPI Mental Health Counselor · Broadway, VA
NPI 1053933549 · NPPES record last updated May 7, 2020
Key facts
- NPI
- 1053933549
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 0704011496 (VA)
- Practice address
- 333 Windermere Dr
Broadway, VA 22815-9489 - Phone
- (540) 333-4728
- NPI assigned
- May 7, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
897 W Lee Hwy
New Market, VA 22844-9548
Phone (540) 333-4728
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241230000505 | VA | Practitioner - Mental Health Counselor | 3173050317 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0704011496 | VA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ometz Counseling LLC | Current |
Accepting new patients | |
| Rocktown Counseling LLC | Past |
Accepting new patients |
Locations
897 W Lee Hwy
New Market, VA 22844
Phone (540) 333-4728
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0704011496 | VA | Yes |
Addresses
Primary practice location
333 Windermere Dr
Broadway, VA 22815-9489
Mailing address
1855 E Lee Hwy
New Market, VA 22844-3221
Phone (540) 333-4728
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dale@rocktowncounseling.com | Direct |
Other providers in Broadway, VA
- Logan Daniel Morrison
- Nelson L Showalte Ta Broadway Drug Center
- Nelson L Showalter Ta Broadway Drug Center
- Melissa Lynn Oczkowski
- Anna Elizabeth Patterson
- Donald Edward Rellins Jr.
- Jill Frankhouser Rice
- Robin D Breeden LCSW PLC
- Rooted and Restored LLC
- Jane Reid See
All providers in Broadway, VA · Mental Health Counselor in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.