Nathan Gilbert Derrickson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12124-C Issued in AR

Practice address

400 W Capitol Ave Ste 1700
Little Rock, AR 72201-3438

Phone

(646) 941-7645

NPI assigned

Sep 3, 2025

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1265312086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ESTES WAY",
            "city": "SOUTHSIDE",
            "state": "AR",
            "postal_code": "725017049",
            "telephone_number": "417-399-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W CAPITOL AVE STE 1700",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722013438",
            "telephone_number": "646-941-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICKSON",
        "first_name": "NATHAN",
        "middle_name": "GILBERT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "12124-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Department of Veterans Affairs
• Tamera Depriest
• Derlis Martino MD PA
• Dermatology Care of Arkansas, PLLC
• Dermatology Group of Arkansas, P.a.
• Alexis Marie Derrigo, MD
• Ankur Naran Desai, RRT
• Rohan Desai, PA-C
• Shefali N Desai
• Shivang K Desai, MD

• Clinical Social Worker in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.