NPIMap

Organization Active NPI

Webster Cantrell Youth Advocacy

  • Mental Health Counselor
  • Decatur, IL
National Provider Identifier
1477184406
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WEBSTER CANTRELL YOUTH ADVOCACY
Practice address
1220 Underwood CT
Decatur, IL 62526-1983
Phone
(217) 233-6811
Fax
(217) 233-6810
NPI assigned
Jan 29, 2020
Organization subpart
Yes
Parent organization
WEBSTER CANTRELL YOUTH ADVOCACYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Authorized official

Name
Mr. Michael Warner, MS.ED, LCPC, CADC
Title
Ceo
Phone
(217) 423-6961

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

1220 Underwood CT
Decatur, IL 62526-1983

Mailing address

1942 E Cantrell St
Decatur, IL 62521-3214
Phone (217) 423-6961

Other names 1

  • Staley Counseling Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Webster Cantrell Youth Advocacy4 organizations share this tax ID, including this one
Part of
Webster Cantrell Youth Advocacy

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1220 Underwood Ct
Decatur, IL 62526
Phone (217) 233-6811

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621209600000",
    "number": "1477184406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1942 E CANTRELL ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213214",
            "telephone_number": "217-423-6961",
            "fax_number": "217-421-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 UNDERWOOD CT",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625261983",
            "telephone_number": "217-233-6811",
            "fax_number": "217-233-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEBSTER CANTRELL YOUTH ADVOCACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEBSTER CANTRELL YOUTH ADVOCACY",
        "enumeration_date": "2020-01-29",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A",
        "authorized_official_last_name": "WARNER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-423-6961",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS.ED, LCPC, CADC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Staley Counseling Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Staley Counseling Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 May 17, 2021; 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.