Individual provider Active NPI

Daniel Ray Pickel, LCSW

  • Clinical Social Worker
  • Jbsa-Lackland, TX
National Provider Identifier
1487836565
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23535 Issued in TX
Practice address
1100 Wilford Hall Loop, BLDG 4554
Attn: 59 MDW/SGHC
Jbsa-Lackland, TX 78236
Phone
(210) 292-6225
NPI assigned
Nov 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 23535 TX Primary

Addresses

Primary practice location

1100 Wilford Hall Loop, BLDG 4554
Attn: 59 MDW/SGHC
Jbsa-Lackland, TX 78236

Mailing address

1100 Wilford Hall Loop, BLDG 4554
Attn: 59 MDW/SGHC
Jbsa-Lackland, TX 78236-9908
Phone (210) 292-6225

Other practice location 1

24202 Palo Duro Peak
San Antonio, TX 78255
Phone (623) 377-6324

Other identifiers 1

IdentifierTypeStateIssuer
432045899MedicaidME

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
23535TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1487836565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP, BLDG 4554",
            "address_2": "ATTN: 59 MDW/SGHC",
            "city": "JBSA-LACKLAND",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-292-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP, BLDG 4554",
            "address_2": "ATTN: 59 MDW/SGHC",
            "city": "JBSA-LACKLAND",
            "state": "TX",
            "postal_code": "78236",
            "telephone_number": "210-292-6225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24202 Palo Duro Peak",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "78255",
            "country_code": "US",
            "telephone_number": "623-377-6324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICKEL",
        "first_name": "DANIEL",
        "middle_name": "RAY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-30",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "23535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432045899",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa-Lackland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.