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MR. JERRY LYNN DOUGLAS LCSW
NPI 1841394939
Social Worker - Clinical in Decatur, IL

Active since September 11, 2006
1770 E LAKESHORE DR, SUITE 209, DECATUR, IL 62521(217) 423-6500(217) 423-6536 Get Directions Write a Review

NPPES record last updated: February 11, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Jerry Lynn Douglas Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JERRY LYNN DOUGLAS LCSW (NPI 1841394939) is an individual clinical provider in Decatur, Illinois and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1841394939
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. JERRY LYNN DOUGLASCredential: LCSW
Location Address1770 E LAKESHORE DR, SUITE 209Decatur, IL 62521
Mailing Address1770 E Lakeshore Dr, Suite 209Decatur, IL 62521 · (217) 423-6500 · Fax (217) 423-6536
Phone(217) 423-6500
Fax(217) 423-6536
Sole ProprietorNo
Enumeration DateSeptember 11, 2006
Last NPPES UpdateFebruary 11, 2021
NPPES CertifiedFebruary 11, 2021
✔ NPI 1841394939 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 149011257 (IL)
1770 E LAKESHORE DR, Decatur, IL 62521
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROHIDAS T. PATIL MD
Psychiatry & Neurology (Psychiatry)
1770 E LAKESHORE DR, STE 209
DECATUR, IL 62521
Macon County (217) 423-6500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerry Douglas's NPI number?

The NPI number for Jerry Douglas is 1841394939. It was assigned to this individual provider in the NPPES registry on September 11, 2006.

Where is Jerry Douglas located?

Jerry Douglas practices at 1770 E Lakeshore Dr Suite 209, Decatur, IL 62521. The listed phone number is (217) 423-6500.

What is Jerry Douglas's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Jerry Douglas was last updated on February 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.