NPIMap

Organization Active NPI

Abc Counseling & Family Services

  • Clinical Social Worker
  • Decatur, IL
National Provider Identifier
1639418676
Registry record updated Nov 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
198405 Issued in IL
Legal business name
ABC COUNSELING & FAMILY SERVICES
Practice address
1110 Arbor Dr
Ste a
Decatur, IL 62526-9285
Phone
(309) 877-9217
Fax
(309) 877-9218
NPI assigned
Feb 12, 2013
Last updated
Nov 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2016

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

Authorized official

Name
Lynn Willard, LCPC, LCSWNPI 1659678241
Title
Executive Director
Phone
(309) 451-9495

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Clinical Social Worker 1041C0700X 198405 IL Primary

Addresses

Primary practice location

1110 Arbor Dr
Ste a
Decatur, IL 62526-9285

Mailing address

1110 Arbor Dr
Ste a
Decatur, IL 62526-9285
Phone (309) 877-9217

Other identifiers 1

IdentifierTypeStateIssuer
2A00-IPI-175MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Abc Counseling Family Services11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

1110 Arbor Dr
Ste A
Decatur, IL 62526
Phone (217) 413-8331

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479772800000",
    "number": "1639418676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 ARBOR DR",
            "address_2": "STE A",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625269285",
            "telephone_number": "309-877-9217",
            "fax_number": "309-877-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 ARBOR DR",
            "address_2": "STE A",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625269285",
            "telephone_number": "309-877-9217",
            "fax_number": "309-877-9218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC COUNSELING & FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-12",
        "last_updated": "2016-11-22",
        "status": "A",
        "authorized_official_last_name": "WILLARD",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "309-451-9495",
        "authorized_official_credential": "LCPC, LCSW"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "198405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2A00-IPI-175",
            "state": "IL"
        }
    ],
    "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 Nov 22, 2016; 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.