Timothy P Pickerrell, LCSW-I

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

133 Integra Breeze LN Unit 104
Daytona Beach, FL 32117-5584

Phone

(270) 401-6905

NPI assigned

Dec 11, 2017

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

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1710492913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 INTEGRA BREEZE LN UNIT 104",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 INTEGRA BREEZE LN UNIT 104",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175584",
            "telephone_number": "270-401-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKERRELL",
        "first_name": "TIMOTHY",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "LCSW-I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-11",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Phillips, LMT
• Renee Gayle Phipps, O.D.
• Physical Therapy & Wellness in Motion, Inc
• Debby Piatek, OTR/L
• Eric Stephen Piazza, PA
• True Charris Pienaar
• Jordan Baxter Pierce, M.D.
• Christina Maria Pierelli, HIS
• Marie Ange Pierre Pierre Juste
• Willythssa Pierre-Louis, M.D

• Clinical Social Worker in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; 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.