Individual Healthcare Provider
Demitrius Brackett, OWNER/DO
Provider's NPPES record last updated: January 28, 2026
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1053911479
- Primary Specialty
- Psychologist — Cognitive & Behavioral
- Practice Location
- Joliet, Illinois
- Sole Proprietor
- Yes
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 3:24 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Psychologist
Cognitive & Behavioral
Behavioral Health & Social Service Providers
A psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking.
Taxonomy code 103TB0200X Adult Companion
Nursing Service Related Providers
An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care.
Taxonomy code 372600000XCounselor
Mental Health
Behavioral Health & Social Service Providers
Definition to come...
Taxonomy code 101YM0800XMeals
Other Service Providers
A public or privately owned facility providing meals to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
Taxonomy code 174200000X
Provider-Reported License Information
- Psychologist (Illinois)
- AC-6153-55852005
- Adult Companion (Illinois)
- AC-6153-55852005
- Counselor (Illinois)
- AC-6153-55852005
- Meals (Illinois)
- AC-6153-55852005
Practice Locations
Practice Location
411 N Bluff St Apt 11
Joliet, Illinois 60435-7295
Phone: (815) 766-5999
Record Information
- Enumeration Date
- October 26, 2020
- Provider's NPPES Record Last Updated
- January 28, 2026
- Certification Date
- January 28, 2026
- NPISignal NPPES Dataset
- August 2026
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