Derek Pendleton, LCSW, ACSW, BCD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW017977 Issued in PA

Practice address

1210 Old York Rd
Suite 202
Warminster, PA 18974-2013

Phone

(215) 444-9204

Fax

(215) 444-9206

NPI assigned

Sep 23, 2011

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

State licenses

Practice roles

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

• Ivyland Counseling Center, Inc.

  • Clinical Psychologist
  • Warminster, PA
  • NPI 1497837355
  NPD (past)

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1831472018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 OLD YORK RD",
            "address_2": "SUITE 202",
            "city": "WARMINSTER",
            "state": "PA",
            "postal_code": "189742013",
            "telephone_number": "215-444-9204",
            "fax_number": "215-444-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 OLD YORK RD",
            "address_2": "SUITE 202",
            "city": "WARMINSTER",
            "state": "PA",
            "postal_code": "189742013",
            "telephone_number": "215-444-9204",
            "fax_number": "215-444-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDLETON",
        "first_name": "DEREK",
        "credential": "LCSW, ACSW, BCD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-23",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard H Patt, M.D.
• Paul M Shipkin M.D., P.C.
• Brittany Paul
• Payne Opticians
• Scott Jason Pello, M.D.
• Pennsylvania CVS Pharmacy, L.L.C.
• Pennsylvania CVS Pharmacy, L.L.C.
• Jeffrey Hugh Perlson, DO
• Philadelphia Emergency Medical Services
• Preeti Philip, PHARMD

• Clinical Social Worker in Warminster, PA
• Providers in Warminster, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.