Individual provider Active NPI

Deborah Diane Cockreham, L.P.C.

  • Counselor
  • Cheyenne, WY
National Provider Identifier
1649436288
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC-787 Issued in WY
Practice address
601 Randall Ave
Cheyenne, WY 82001-2746
Phone
(307) 287-7847
Fax
(307) 635-3965
NPI assigned
Aug 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4815 CO
Counselor 101Y00000X LPC-787 WY Primary
Professional Counselor 101YP2500X LPC-787 WY

Addresses

Primary practice location

601 Randall Ave
Cheyenne, WY 82001-2746

Mailing address

5044 Cinquefoil LN Unit F
Fort Collins, CO 80528-4522
Phone (307) 287-7847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241025003651 WY Practitioner - Mental Health Counselor 1759814957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

601 Randall Ave
Cheyenne, WY 82001-2746
Phone (307) 287-7847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-787WYMDCounselor
4815COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Living Positively on Purpose PC Professional CurrentSince Feb 15, 2024 Accepting new patients

Locations

601 Randall Ave
Cheyenne, WY 82001
Phone (307) 287-7847

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": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1649436288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5044 CINQUEFOIL LN UNIT F",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805284522",
            "telephone_number": "307-287-7847",
            "fax_number": "307-635-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 RANDALL AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820012746",
            "telephone_number": "307-287-7847",
            "fax_number": "307-635-3965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCKREHAM",
        "first_name": "DEBORAH",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "4815",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WY",
            "license": "LPC-787",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "LPC-787",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.