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JERRY CROCKRELL
NPI 1245799378
Counselor - Addiction (Substance Use Disorder) in Manteno, IL

Active since March 18, 2019
411 W DIVISION ST, MANTENO, IL 60950(815) 432-5241 Get Directions Write a Review

NPPES record last updated: March 17, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 17, 2020, Mar 18, 2019 (2 updates tracked since 2019).

About Jerry Crockrell NPPES

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

JERRY CROCKRELL (NPI 1245799378) is an individual addiction (substance use disorder) provider in Manteno, Illinois and active in the NPI registry since March 2019.

NPPES Registry Identity

NPI1245799378
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameJERRY CROCKRELL
Location Address411 W DIVISION STManteno, IL 60950-1065
Mailing Address136 N Arbor TrlPark Forest, IL 60466-2604 · (708) 513-3494
Phone(815) 432-5241
Sole ProprietorNo
Enumeration DateMarch 18, 2019
Last NPPES UpdateMarch 17, 20202 updates tracked since enumeration
NPPES CertifiedMarch 17, 2020
✔ NPI 1245799378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
411 W DIVISION ST, Manteno, IL 60950
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Other Providers at the Same Location NPPES 20

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

MARGARET GARAY SULLIVAN LCPC CADC/ATE MISAII
Counselor (Professional)
411 W DIVISION ST
MANTENO, IL 60950
Kankakee County (815) 468-3241
IROQUOIS MENTAL HEALTH CENTER
Clinic/Center (Rehabilitation, Substance Use Disorder)
411 W DIVISION ST
MANTENO, IL 60950
Kankakee County (815) 432-5241
GREGORY JEN CADC
Counselor (Addiction (Substance Use Disorder))
411 W DIVISION ST
MANTENO, IL 60950
Kankakee County (815) 432-5241
KATHLEEN LUND CADC
Counselor (Addiction (Substance Use Disorder))
411 W DIVISION ST
MANTENO, IL 60950
Kankakee County (815) 432-5241
REYNA HAMMERLUND CADC
Counselor (Addiction (Substance Use Disorder))
411 W DIVISION ST
MANTENO, IL 60950
Kankakee County (815) 432-5241
HELEN RIBERDY
Counselor (Addiction (Substance Use Disorder))
411 W DIVISION ST
MANTENO, IL 60950
Kankakee County (815) 432-5241
BRIAN FINKELSTEIN CADC
Counselor (Addiction (Substance Use Disorder))
411 W DIVISION ST
MANTENO, IL 60950
Kankakee County (815) 432-5241
JULIE WEISHAAR RN
Registered Nurse (Psychiatric/Mental Health)
411 W DIVISION ST
MANTENO, IL 60950
Kankakee County (815) 432-5241

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 Jerry Crockrell's NPI number?

The NPI number for Jerry Crockrell is 1245799378. It was assigned to this individual provider in the NPPES registry on March 18, 2019.

Where is Jerry Crockrell located?

Jerry Crockrell practices at 411 W Division St, Manteno, IL 60950. The listed phone number is (815) 432-5241.

What is Jerry Crockrell's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Jerry Crockrell was last updated on March 17, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.