1. Home
  2. Directory
  3. Illinois
  4. Champaign
  5. Social Worker
  6. NPI Profile

JEANIE MICKELSEN LCPC
NPI 1710510136
Social Worker in Champaign, IL

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: November 08, 2026.

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
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Jeanie Mickelsen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Carle Health Medical Group
3.5 mi
Internal Medicine
611 W PARK ST
Urbana, IL 61801
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Carle Health Care Incorporated
  • 2,516 clinicians in this Medicare group
NPI 1154653947 (217) 383-8300
Hoopeston Community Memorial Hospital
39 mi
Critical Access
701 E ORANGE ST
Hoopeston, IL 60942
  • Reassigned Medicare billing, Illinois enrollment
  • 88 clinicians in this Medicare group
NPI 1366480873 (217) 283-5531

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 255-9580
CARLE CLINIC ASSOCIATION, PC
Durable Medical Equipment & Medical Supplies
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 326-1220
DR. GABRIEL SOTOMAYOR M.D.
Physical Medicine & Rehabilitation
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 902-6954
KRISTINE S ANDERSON PA
Physician Assistant (Surgical)
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 383-3260
BRADY W IBA DO
Psychiatry & Neurology (Psychiatry)
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 365-2855
DR. JOHN P BAKER PHD
Psychologist
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 365-2855
SELAHATTIN GOKTURK M.A
Social Worker (Clinical)
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 383-1850
AMANDA GAUGLER
Social Worker (Clinical)
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 365-2855

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 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.

Where is Jeanie Mickelsen located?

Jeanie Mickelsen practices at 1802 S Mattis Ave, Champaign, IL 61821. The listed phone number is (217) 383-1850.

What is Jeanie Mickelsen's specialty?

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

Is Jeanie Mickelsen enrolled in Medicare?

Yes. Jeanie Mickelsen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jeanie Mickelsen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeanie Mickelsen reassigns Medicare benefits to 2 organizations: Carle Health Medical Group (Urbana, IL) and Hoopeston Community Memorial Hospital (Hoopeston, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jeanie Mickelsen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

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.