Demitrius Brackett, OWNER/DO
NPI 1053911479ActiveIndividual· Psychologist, Cognitive & Behavioral· Joliet, IL
Psychologist, Cognitive & Behavioral (OWNER/DO) in Joliet, Illinois, licensed in IL, with an NPI issued in October 2020.
Overview
| NPI | 1053911479 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | OWNER/DO |
| Sole proprietor | Yes |
| NPI issued | Oct 26, 2020 |
| Last updated in NPPES | Jan 28, 2026 |
| Certified by provider | Jan 28, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Cognitive & Behavioral Primary | 103TB0200X | AC-6153-55852005 | IL |
| Adult Companion | 372600000X | AC-6153-55852005 | IL |
| Counselor, Mental Health | 101YM0800X | AC-6153-55852005 | IL |
| Meals | 174200000X | AC-6153-55852005 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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