Individual provider Active NPI

Sherry Marie Dockins, LCPC

  • Professional Counselor
  • Peoria, IL
National Provider Identifier
1285774133
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180006006 Issued in IL
Practice address
7617 N Villa Wood LN
Peoria, IL 61614-1588
Phone
(309) 693-8200
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180006006 IL Primary

Addresses

Primary practice location

7617 N Villa Wood LN
Peoria, IL 61614-1588

Mailing address

228 N Vernon St
Princeton, IL 61356-1715
Phone (815) 872-0474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
180006006ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Joy Miller Professional PastSince Nov 1, 2011 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1285774133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 N VERNON ST",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613561715",
            "telephone_number": "815-872-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7617 N VILLA WOOD LN",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141588",
            "telephone_number": "309-693-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCKINS",
        "first_name": "SHERRY",
        "middle_name": "MARIE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180006006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; 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.