Ivy Ting Pickell, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801118246 Issued in MI

Practice address

1 Heritage Dr Ste 520
Southgate, MI 48195-3051

Phone

(734) 215-9800

NPI assigned

Dec 20, 2021

Last updated

Aug 20, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Richard Kneip, PH.D., P.C.

  dba Great Lakes Psychology Group

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  Medicare reassignment NPD

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1548920440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15490 SUSAN ST",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HERITAGE DR STE 520",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481953051",
            "telephone_number": "734-215-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41700 Gardenbrook Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483751320",
            "country_code": "US",
            "telephone_number": "248-202-5698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICKELL",
        "first_name": "IVY",
        "middle_name": "TING",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801118246",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801118246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Pfeiffer
• Wanda Denise Phelps
• Phillips Eye Care, P.L.L.C.
• Daniel Phillips, O.D.
• Wilbur Eugene Phillips, O.D.
• Elizabeth Shannon Pierson
• Lanie Pifer
• Porsche Piggie, LIMITED LICENSE PSY
• Nicholas Michael Pikaart, MSW
• Pinnacle Pulmonary Strategies LLC

• Social Worker in Southgate, MI
• Providers in Southgate, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.