KATIE COCKRELL LCSW
NPI 1124416854
Social Worker - Clinical in Wheaton, IL

Active since January 05, 2015Opted out of Medicare · through Dec 6, 2026
2100 MANCHESTER RD STE 1510, WHEATON, IL 60187(630) 653-1717(630) 653-7926 Get Directions Write a Review

NPPES record last updated: January 5, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Katie Cockrell Lcsw NPPES

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

KATIE COCKRELL LCSW (NPI 1124416854) is an individual clinical provider in Wheaton, Illinois, licensed in Illinois (149.016479) and active in the NPI registry since January 2015. She has opted out of Medicare through December 6, 2026.

NPPES Registry Identity

NPI1124416854
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKATIE COCKRELLCredential: LCSW
Location Address2100 MANCHESTER RD STE 1510Wheaton, IL 60187-4561
Mailing Address2100 Manchester Rd Ste 1510Wheaton, IL 60187-4561 · (630) 653-1717 · Fax (630) 653-7926
Fax(630) 653-7926
Sole ProprietorYes
Enumeration DateJanuary 5, 2015
NPI 1124416854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in IL · 149.016479
Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

2100 MANCHESTER RD STE 1510, Wheaton, IL 60187

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Katie Cockrell Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 6, 2022 through December 6, 2026.

Opt-Out Effective DateDecember 6, 2022
Opt-Out In Effect ThroughDecember 6, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (Clinical)
2100 MANCHESTER RD STE 1510
WHEATON, IL 60187
Student in an Organized Health Care Education/Training Program
2100 MANCHESTER RD STE 1510
WHEATON, IL 60187
Nurse Practitioner (Psychiatric/Mental Health)
2100 MANCHESTER RD STE 1510
WHEATON, IL 60187
Social Worker (Clinical)
2100 MANCHESTER RD STE 1510
WHEATON, IL 60187
Counselor (Professional)
2100 MANCHESTER RD STE 1510
WHEATON, IL 60187
Counselor (Professional)
2100 MANCHESTER RD STE 1510
WHEATON, IL 60187
Counselor (Professional)
2100 MANCHESTER RD STE 1510
WHEATON, IL 60187
Psychologist (Clinical)
2100 MANCHESTER RD STE 1510
WHEATON, IL 60187

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1124416854, enumerated as an "individual" on January 05, 2015.

The provider is located at 2100 MANCHESTER RD STE 1510 WHEATON, IL 60187 and the phone number is (630) 653-1717.

Social Worker with taxonomy code 1041C0700X and a focus in Clinical.