Jacquelina Deanna Pickett, LMSW

Key facts

NPI

1639635873

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

MSW007005 (GA)

Practice address

1727 Wrightsboro Rd
Augusta, GA 30904-4049

Phone

(706) 364-9730

NPI assigned

Feb 12, 2019

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

National Provider Directory

Medicare enrollment (NPD)

Yes

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 12, 2019.

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1639635873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 WRIGHTSBORO RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044049",
            "telephone_number": "706-364-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 WRIGHTSBORO RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044049",
            "telephone_number": "706-364-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "JACQUELINA",
        "middle_name": "DEANNA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "MSW007005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

• Physicians Practice Group
• Physicians United Urgent Care
• Physiotherapy Associates Inc
• Charlton Judson Pickett, M.D.
• Genniffer Pickett
• Pidcock Chiropractic, Inc.
• Scott J. Pidcock, D.C.
• Briggitte Pierce, LPN
• Debra Lynn Pierce, PH.D.
• Larry H. Pierce, M.D.

All providers in Augusta, GA · Clinical Social Worker in Georgia