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NPI Code Detail

MEDICARE: MR. ROBERT DARRELL PICKARD SR. LPCC

MEDICARE: MR. ROBERT DARRELL PICKARD SR. LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorC 0800106OH
2101YM0800XMental Health CounselorE.0800106OH

General Provider Information

NPI Number : 1720313638
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT DARRELL PICKARD SR. LPCC
Provider Business Mailing Address
First Line : 355 S BELVOIR BLVD
Second Line :
City : SOUTH EUCLID
State : OH
Zip : 44121-2348
Country : US
Telephone Number : 216-531-9580
Fax Number : 216-531-9581
Provider Business Practice Location Address
First Line : 10427 DETROIT AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-1645
Country : US
Telephone Number : 216-694-7200
Fax Number : 216-521-6006
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2009
Last Update Date : 02/04/2016

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