Organization · Type 2 NPI
1402 Cockrell LLC
Mental Health Clinic/Center (Including Community Mental Health Center) · Springfield, IL
NPI number
1184590747
Active
Practice location
4012 Cockrell Ln
Springfield, IL 62711-8327
Mailing address
6317 N Monticello Ave
Chicago, IL 60659-1209
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | None listed |
| Mental Health Clinic/Center (Including Community Mental Health Center) Primary | 261QM0801X | None listed |
| Adult Mental Health Clinic/Center | 261QM0850X | None listed |
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | None listed |
Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...
Another provider at this address
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About NPI 1184590747
1402 Cockrell LLC's National Provider Identifier is 1184590747, issued on Oct 13, 2025. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Springfield, IL. The record was last updated on Oct 13, 2025.