Individual provider Active NPI

Robert L Cokley, PHD

  • Clinical Social Worker
  • Decatur, IL
National Provider Identifier
1972611077
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
348 W Prairie Ave
Ste 3
Decatur, IL 62522-2471
Phone
(217) 422-0053
Fax
(217) 422-0374
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X IL Primary

Addresses

Primary practice location

348 W Prairie Ave
Ste 3
Decatur, IL 62522-2471

Mailing address

348 W Prairie Ave
Ste 3
Decatur, IL 62522-2471
Phone (217) 422-0053

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
149000865ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972611077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 W PRAIRIE AVE",
            "address_2": "STE 3",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625222471",
            "telephone_number": "217-422-0053",
            "fax_number": "217-422-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 W PRAIRIE AVE",
            "address_2": "STE 3",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625222471",
            "telephone_number": "217-422-0053",
            "fax_number": "217-422-0374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COKLEY",
        "first_name": "ROBERT",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.