Active NPI
Kimberly Kay Pickett, LISW
- Clinical Social Worker
- Pella, IA
National Provider Identifier
1114165537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 01024
- Practice address
- 404 Jefferson St
Pella, IA 50219-1257 - Phone
- (641) 628-3150
- NPI assigned
- Jan 22, 2009
- Last updated
- Aug 13, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 01024 | IA | Primary |
Addresses
Primary practice location
404 Jefferson St
Pella, IA 50219-1257
Mailing address
404 Jefferson St
Pella, IA 50219-1257
Phone (641) 672-3150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01024 | IA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344816000000",
"number": "1114165537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 JEFFERSON ST",
"city": "PELLA",
"state": "IA",
"postal_code": "502191257",
"telephone_number": "641-672-3150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 JEFFERSON ST",
"city": "PELLA",
"state": "IA",
"postal_code": "502191257",
"telephone_number": "641-628-3150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICKETT",
"first_name": "KIMBERLY",
"middle_name": "KAY",
"name_prefix": "Mrs.",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-22",
"last_updated": "2012-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IA",
"license": "01024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pella, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.