Nicole Cockram, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

22455 Issued in MN

Practice address

1880 Austin Rd
Owatonna, MN 55060-4543

Phone

(507) 202-4158

NPI assigned

Jul 12, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Full Circle Counseling and Wellness, PCGroup PAC ID 0547643298, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Full Circle Counseling and Wellness, PC

  • Mental Health Counselor
  • Owatonna, MN
  • NPI 1831739788
  Medicare reassignment Care Compare group NPD
• Experiencing Moore, PC

  • Marriage & Family Therapist
  • Owatonna, MN
  • NPI 1740666122
  NPD (past)

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1922584069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 AUSTIN RD",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550604543",
            "telephone_number": "507-202-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 AUSTIN RD",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550604543",
            "telephone_number": "507-202-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCKRAM",
        "first_name": "NICOLE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "22455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI II",
            "identifier": "1831739788",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Christianson
• Tyler Todd Clark
• Katherine Louise Clubb, M.D.
• Coborns Inc
• Mark James Cochran, DC,ND
• Dawn Cohen, DC
• Lori A Cole, D.C.
• Lyle Charles Coleman, D.C., DIBCN
• Deanna Leigh Collins, PMHNP-BC
• Kayla Marie Cook, PA-C

• Social Worker in Owatonna, MN
• Providers in Owatonna, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.