Demitrius Brackett, OWNER/DO

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

AC-6153-55852005 Issued in IL

Practice address

411 N Bluff St Apt 11
Joliet, IL 60435-7295

Phone

(815) 766-5999

NPI assigned

Oct 26, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Forevermore Mind Body & Soul

  dba Forevermore Healthcare

  • Clinic/Center
  • Joliet, IL
  • NPI 1346025285

  Meals

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1053911479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N OTTAWA ST APT 209",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604324080",
            "telephone_number": "815-766-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N BLUFF ST APT 11",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604357295",
            "telephone_number": "815-766-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKETT",
        "first_name": "DEMITRIUS",
        "credential": "OWNER/DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-26",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "IL",
            "license": "AC-6153-55852005",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "IL",
            "license": "AC-6153-55852005",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "AC-6153-55852005",
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": "IL",
            "license": "AC-6153-55852005",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Bowman, SSP
• Ellise Jeannette Boyd, MAED
• Jessica L Boyd, PT
• Joanne Boyd
• Rachel Brace
• Kim Katherine Bradley
• Caitlin Bragg
• Andrew Bramer, PA-C
• Julie Branchaw, LPC
• Bravo Care of Joliet Inc (Rosewood Care Center of Joliet)

• Cognitive & Behavioral Psychologist in Joliet, IL
• Providers in Joliet, IL by specialty
• Cognitive & Behavioral Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.