Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jomon John Thekkethottiyil

Individual provider Clinical Social Worker · NPI 1023376894

Jomon John Thekkethottiyil is a Clinical Social Worker in St Petersburg, Florida. Qualified in 2003, 23 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
23
Licensed in
FL
In the registry since
2012
Specialties on file
2
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Practice location Address checks out

4024 Central Ave
St Petersburg, FL 33711-1239
Phone: (727) 327-7656
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence SW10806 (FL)
Counselor Taxonomy 101Y00000X · Licence SW10806 (FL)

Record details

NPI number1023376894
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 30, 2012
Last updated in NPPESJune 18, 2012

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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