Daniel J Pezzulo, PHD, ABSNP, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW012774 Issued in PA

Practice address

154 Esther Dr
Lancaster, PA 17601-2047

Phone

(717) 413-2731

Fax

(717) 413-2731

NPI assigned

Dec 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1992789531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 ESTHER DR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012047",
            "telephone_number": "717-413-2731",
            "fax_number": "717-413-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 ESTHER DR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012047",
            "telephone_number": "717-413-2731",
            "fax_number": "717-413-2731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZZULO",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD, ABSNP,  LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2023-09-08",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "PA",
            "license": "04043671",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW012774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "627225",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Lancaster, PA
• Providers in Lancaster, 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 Sep 8, 2023; 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.