JACQUELINE HENRICHS
NPI 1306105051
Social Worker - Clinical in Champaign, IL

Q: What is Jacqueline Henrichs's NPI number?

The NPI number for Jacqueline Henrichs is 1306105051. It was assigned to this individual provider in the NPPES registry on May 15, 2012.

Q: What is Jacqueline Henrichs's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since May 15, 2012PECOS EnrolledAccepts Medicare Assignment

1802 S MATTIS AVE, CHAMPAIGN, IL 61821(217) 365-2855 Get Directions Write a Review

NPPES record last updated: November 26, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 26, 2019, Jul 16, 2019 (2 updates tracked since 2019).

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About Jacqueline Henrichs NPPES

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

JACQUELINE HENRICHS (NPI 1306105051) is an individual clinical provider in Champaign, Illinois, licensed in Illinois (149017167) and active in the NPI registry since May 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1306105051

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameJACQUELINE HENRICHS

Location Address1802 S MATTIS AVEChampaign, IL 61821-5923

Mailing Address1802 S Mattis AveChampaign, IL 61821-5923

Phone(217) 365-2855

Sole ProprietorYes

Medical School CMSOtherGraduated 2012

Enumeration DateMay 15, 2012

Last NPPES UpdateNovember 26, 20192 updates tracked since enumeration

✔ NPI 1306105051 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in IL · 149017167

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.

Also ListedSocial WorkerTaxonomy 104100000X

1802 S MATTIS AVE, Champaign, IL 61821

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacqueline Henrichs is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3577974427

PECOS Enrollment IDI20201124002868

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61821 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $54.80 – $168.44

Typical copayment $0.00 (range $13.70 – $42.11)

Most-billed visit code NA

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

RACHAEL D RUBIN PHD

Psychologist