1402 Cockrell LLC
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Springfield, IL
NPI 1184590747 · NPPES record last updated Oct 13, 2025
Key facts
- NPI
- 1184590747
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- 1402 COCKRELL LLC
- Practice address
- 4012 Cockrell LN
Springfield, IL 62711-8327 - Phone
- (847) 324-3543
- NPI assigned
- Oct 13, 2025
- Organization subpart
- No
Authorized official
- Name
- Sariah Hopkins, CHC
- Title
- Compliance Officer
- Phone
- (847) 324-3543
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes | ||
| Adult Mental Health Clinic/Center | 261QM0850X | |||
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X |
Addresses
Primary practice location
4012 Cockrell LN
Springfield, IL 62711-8327
Mailing address
6317 N Monticello Ave
Chicago, IL 60659-1209
Phone (847) 324-3543
Other names
- Duad Wellness
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All providers in Springfield, IL · Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.