| Doctor Name: | MR. RANDALL ALAN PICKERING |
| NPI Number: | 1003932922 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 34003281A |
| Business Practice Address: | 1116 N 16th St Lafayette, IN - 479042119 |
| Business Phone Number: | 7653378420 |
| Business Fax Number: | 7654285850 |
| Mailing Address: | 1040 Sierra Dr, Suite 400 GREENWOOD |
| State: | IN |
| Postal Code: | 461437240 |
| Phone Number: | 3175284800 |
| Fax Number: | 3178598239 |
| NPI Enumeration Date: | 03/22/2007 |
| NPI Last Update Date: | 07/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 34003281A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |