DEMITRIUS BRACKETT OWNER/DO
NPI 1053911479
Psychologist - Cognitive & Behavioral in Joliet, IL
NPI Status: Active since October 26, 2020
Contact Information
411 N BLUFF ST APT 11
JOLIET, IL
ZIP 60435
Phone: (815) 766-5999
- Individual
- Male
- Psychologist
- Cognitive & Behavioral
About DEMITRIUS BRACKETT
This page provides the complete NPI Profile along with additional information for Demitrius Brackett, a provider established in Joliet, Illinois with a medical specialization in Psychologist, focusing in cognitive & behavioral . The healthcare provider is registered in the NPI registry with number 1053911479 assigned on October 2020. The practitioner's primary taxonomy code is 103TB0200X with license number AC-6153-55852005 (IL). The provider is registered as an individual and his NPI record was last updated January 2026.
- NPI
- 1053911479
- Provider Name
- DEMITRIUS BRACKETT OWNER/DO
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 411 N BLUFF ST APT 11 JOLIET, IL 60435
- Location Phone
- (815) 766-5999
- Mailing Address
- 311 N OTTAWA ST APT 209 JOLIET, IL 60432
- Mailing Phone
- (815) 766-5999
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 10-26-2020
- Last Update Date
- 01-28-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist Cognitive & Behavioral
- Taxonomy Code
- 103TB0200X
- Type
- Behavioral Health & Social Service Providers
- License No.
- AC-6153-55852005
- License State
- IL
- Taxonomy Description
- A psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | AC-6153-55852005 (IL) |
| 2 | 174200000X | Other Service Providers | Meals | AC-6153-55852005 (IL) |
| 3 | 372600000X | Nursing Service Related Providers | Adult Companion | AC-6153-55852005 (IL) |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1053911479, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 51 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1053911479, enumerated as an "individual" on October 26, 2020.
The provider is located at 411 N BLUFF ST APT 11 JOLIET, IL 60435 and the phone number is (815) 766-5999.
Psychologist with taxonomy code 103TB0200X and a focus in Cognitive & Behavioral.
