NICOLE COCKRAM (LICSW) – Social Worker, NPI 1922584069

NICOLE COCKRAM (LICSW) is a healthcare provider. based in Owatonna, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 22455 (MN). The NPI Number for NICOLE COCKRAM (LICSW) is 1922584069

Main info

Female
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE COCKRAM (LICSW)
NPI
1922584069
Phone
(507) 774-0049
Address
140 W PEARL ST STE B3
Enumeration Date
12 July 2018
Last Update Date
18 September 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5072142016
Graduation Year
2016 (10 years ago)
PAC ID
5294162178
Group Practice PAC ID
0547643298
Professional Enrollment ID
I20200305002830
Address ID
MN550604544OW1880XRDXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:7State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

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Provider Addresses for NICOLE COCKRAM (LICSW)

  • West Pearl Street, Owatonna, Steele County, Minnesota, 55060, United States

    OWATONNA, MN 550602354

    Phone: (507) 774-0049

    Type: Mailing

  • 125 LANDMARK DR NE STE 2

    OWATONNA, MN 550601629

    Phone: (507) 202-4158

    Type: Mailing

  • 1880 AUSTIN RD

    OWATONNA, MN 550604543

    Phone: (507) 202-4158

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-03-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200305002830IClinical Social WorkerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55060)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0547643298View full group profile
NameSpecialtyState
Clinical Social WorkerMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

How is NICOLE COCKRAM (LICSW) identified in CMS data?
CMS-hosted NPPES data lists NICOLE COCKRAM (LICSW) with NPI 1922584069.
Does CMS list NICOLE COCKRAM (LICSW) as active?
Yes — NICOLE COCKRAM (LICSW) is active in the NPI listing used on this page.
What is NICOLE COCKRAM (LICSW)'s specialty?
The listing groups NICOLE COCKRAM (LICSW) with Social Worker. Clinical services aligned with this taxonomy classification.
Where should I expect NICOLE COCKRAM (LICSW) on a map?
Expect Owatonna, Minnesota as a primary anchor for NICOLE COCKRAM (LICSW) unless the record lists multiple sites.
How many locations tie to this NPI?
6 practice locations appear in the available data.

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