JEANIE MICKELSEN LCPC
NPI 1710510136
Social Worker in Champaign, IL

Q: What is Jeanie Mickelsen's NPI number?

The NPI number for Jeanie Mickelsen is 1710510136. It was assigned to this individual provider in the NPPES registry on February 13, 2020.

Q: What is Jeanie Mickelsen's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Jeanie Mickelsen was last updated on February 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 13, 2020PECOS EnrolledAccepts Medicare Assignment

1802 S MATTIS AVE, CHAMPAIGN, IL 61821(217) 383-1850(217) 383-3439 Get Directions Write a Review

NPPES record last updated: February 13, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jeanie Mickelsen Lcpc NPPES

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

JEANIE MICKELSEN LCPC (NPI 1710510136) is an individual social worker in Champaign, Illinois and active in the NPI registry since February 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1710510136

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameJEANIE MICKELSENCredential: LCPC

Location Address1802 S MATTIS AVEChampaign, IL 61821-5923

Mailing Address611 W. Park St., FapcUrbana, IL 61801

Phone(217) 383-1850

Fax(217) 383-3439

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateFebruary 13, 2020

✔ NPI 1710510136 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

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

Jeanie Mickelsen Lcpc 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 ID244675304

PECOS Enrollment IDI20240228001941

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.

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