Nancy Rae Divis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

31800 Issued in TX

Practice address

819 Water St
Ste 300
Kerrville, TX 78028-5333

Phone

(830) 258-5430

Fax

(830) 792-5771

NPI assigned

Jun 12, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nancy Rae Pickerell Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244764800000",
    "number": "1609003094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 WATER ST",
            "address_2": "STE 300",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285333",
            "telephone_number": "830-258-5430",
            "fax_number": "830-792-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 WATER ST",
            "address_2": "STE 300",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285333",
            "telephone_number": "830-258-5430",
            "fax_number": "830-792-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVIS",
        "first_name": "NANCY",
        "middle_name": "RAE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-12",
        "last_updated": "2009-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "31800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "31800",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "PICKERELL",
            "middle_name": "RAE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dental Trends PLLC
• Department of Veterans Affairs
• Francis F Derk, D.P.M
• Sally Elizabeth Derrough
• Dietert Claim Senior Citizens Center, Inc.
• Meagan Dodd
• Lyndsey Michelle Dominguez, M.D.
• Don N Murrmann MD PA
• Donald Clinton Morris Jr M D P a
• Donna Lamb LCSW PLLC

• Clinical Social Worker in Kerrville, TX
• Providers in Kerrville, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; 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.