NPIMap

Organization Active NPI

Decatur Psychological Associates PC

  • Counselor
  • Decatur, IL
National Provider Identifier
1184732745
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
DECATUR PSYCHOLOGICAL ASSOCIATES PC
Practice address
3040 N University Ave
Suite 2
Decatur, IL 62526-1351
Phone
(217) 872-1700
Fax
(217) 872-1366
NPI assigned
Aug 25, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David Ray Wence, D MIN LCPCNPI 1831209758
Title
President
Phone
(217) 872-1700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X IL
Counselor 101Y00000X IL Primary

Addresses

Primary practice location

3040 N University Ave
Suite 2
Decatur, IL 62526-1351

Mailing address

3040 N University Ave
Suite 2
Decatur, IL 62526-1351
Phone (217) 872-1700

National Provider Directory

National Provider Directory

Locations

3040 N University Ave
Decatur, IL 62526
Phone (217) 872-1700

3040 N University Ave
Ste 2
Decatur, IL 62526
Phone (217) 872-1700

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184732745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 N UNIVERSITY AVE",
            "address_2": "SUITE 2",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625261351",
            "telephone_number": "217-872-1700",
            "fax_number": "217-872-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 N UNIVERSITY AVE",
            "address_2": "SUITE 2",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625261351",
            "telephone_number": "217-872-1700",
            "fax_number": "217-872-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR PSYCHOLOGICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WENCE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-872-1700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D MIN LCPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.