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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. JERRY LYNN DOUGLAS, LCSW

Active

MR. JERRY LYNN DOUGLAS, LCSW is a Clinical Social Worker healthcare provider located in DECATUR, Illinois. NPI 1841394939 is currently active in the NPPES registry. Verify at CMS.

Clinical Social Worker · DECATUR, IL

Registration Details

NPI Number
1841394939
Provider Type
Individual
Gender
Male
NPI Issued
Sep 11, 2006 (19.740290239249 yrs)
Last Updated
Feb 11, 2021
License
149011257 (IL)

Practice Information

Address
1770 E LAKESHORE DR
SUITE 209
DECATUR, IL, 62521
Browse IL providers · Browse ZIP 62521
Phone
2174236500
Fax
2174236536
Primary Specialty
Clinical Social Worker
1041C0700X
Additional Specialty
Clinical Social Worker

Other Clinical Social Worker Providers in DECATUR, IL

Name Credential NPI
SUSAN S BRINKLOW LCSW, ACSW 1174578751
KAREN F COKLEY MSW LCSW 1558479659
ROBERT L COKLEY PHD 1972611077
JANET L. WHITEHEAD L.C.S.W. 1518065119
GENIEL GRABOWSKI LCSW 1811066913
MRS. RUTH ELIZABETH TEEL LCPC 1780753889
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.