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MR. DALE PICKETT III MS, NCC
NPI 1053933549
Counselor - Mental Health in Broadway, VA

Active since May 07, 2020PECOS EnrolledAccepts Medicare Assignment
333 WINDERMERE DR, BROADWAY, VA 22815(540) 333-4728 Get Directions Write a Review

NPPES record last updated: May 7, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mr. Dale Pickett Iii Ms, Ncc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. DALE PICKETT III MS, NCC (NPI 1053933549) is an individual mental health provider in Broadway, Virginia, licensed in Virginia (0704011496) and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1053933549
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. DALE PICKETT IIICredential: MS, NCC
Location Address333 WINDERMERE DRBroadway, VA 22815-9489
Mailing Address1855 E Lee HwyNew Market, VA 22844-3221 · (540) 333-4728
Phone(540) 333-4728
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateMay 7, 2020
NPPES CertifiedMay 7, 2020
✔ NPI 1053933549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in VA · 0704011496
333 WINDERMERE DR, Broadway, VA 22815
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Dale Pickett Iii Ms, Ncc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173050317
PECOS Enrollment IDI20241230000505
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Dale Pickett reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ometz Counseling LLC
5.9 mi
Professional
897 W LEE HWY
New Market, VA 22844
  • Reassigned Medicare billing, Virginia enrollment
NPI 1245950898 (540) 333-4728
Shenandoah County Free Clinic Inc
23 mi
Public Health or Welfare
124 VALLEY VISTA DR
Woodstock, VA 22664
  • Reassigned Medicare billing, Virginia enrollment
  • 3 clinicians in this Medicare group
NPI 1235403361 (540) 459-1700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dale Pickett's NPI number?

The NPI number for Dale Pickett is 1053933549. It was assigned to this individual provider in the NPPES registry on May 7, 2020.

Where is Dale Pickett located?

Dale Pickett practices at 333 Windermere Dr, Broadway, VA 22815. The listed phone number is (540) 333-4728.

What is Dale Pickett's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Dale Pickett enrolled in Medicare?

Yes. Dale Pickett is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Dale Pickett's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dale Pickett reassigns Medicare benefits to 2 organizations: Ometz Counseling LLC (New Market, VA) and Shenandoah County Free Clinic Inc (Woodstock, VA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dale Pickett's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Dale Pickett was last updated on May 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.