Healthcare Provider Details

I. General information

NPI: 1427961713
Provider Name (Legal Business Name): PIVOT POINT THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11824 MAIN ST
ROSCOE IL
61073-9561
US

IV. Provider business mailing address

PO BOX 54
ROSCOE IL
61073-0054
US

V. Phone/Fax

Practice location:
  • Phone: 815-540-2959
  • Fax: 815-301-3429
Mailing address:
  • Phone: 815-540-2959
  • Fax: 815-301-3429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JAMEY LEE DWYER
Title or Position: OWNER, THERAPIST
Credential: MSW, LCSW
Phone: 815-540-2959