Robert Lincoln Mock, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.026754 Issued in IL

Practice address

7327 N Manning Dr
Peoria, IL 61614-1917

Phone

(720) 985-4311

NPI assigned

Apr 23, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734739200000",
    "number": "1487409397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7327 N MANNING DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141917",
            "telephone_number": "720-985-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7327 N MANNING DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141917",
            "telephone_number": "720-985-4311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1629 E Gardner Ln",
            "address_purpose": "LOCATION",
            "city": "Peoria Heights",
            "state": "IL",
            "postal_code": "616163613",
            "country_code": "US",
            "telephone_number": "309-685-1545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOCK",
        "first_name": "ROBERT",
        "middle_name": "LINCOLN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-12-21",
        "certification_date": "2024-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.026754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald E Mitzelfelt, MD
• MJM Family Medicine SC
• William Ted Mlotek, DC
• Muhammad Talha Moazzam, MD
• Mobile Diagnostic Services, Inc
• Zohra F Moeenuddin, M.D.
• Lynna Moenga
• Maryam Moin, M.D.
• Sherry Lee Molburg, MSW
• Michael Momchev, DDS

• Clinical Social Worker in Peoria, IL
• Providers in Peoria, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.