Individual provider Active NPI

Carla Maria Donnelly, LPC

  • Professional Counselor
  • Decatur, IL
National Provider Identifier
1801505151
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.018104 Issued in IL
Practice address
151 N Main St
Decatur, IL 62523-1206
Phone
(172) 362-6262
NPI assigned
Nov 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.018104 IL Primary

Addresses

Primary practice location

151 N Main St
Decatur, IL 62523-1206

Mailing address

151 N Main St
Decatur, IL 62523-1206
Phone (172) 362-6262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250312003613 IL Practitioner - Mental Health Counselor 0941721484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heritage Behavioral Health Center, Inc.Group PAC ID 0547208951, 20 clinicians

Practice addresses (Care Compare)

151 N Main St
Decatur, IL 62523-1206
Phone (217) 362-6262

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178.018104ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Behavioral Health Center, Inc. CurrentSince Mar 1, 2025 Accepting new patients
Heritage Behavioral Health Center CurrentSince Mar 1, 2025 Accepting new patients
Heritage Behavioral Health Center Inc. Current Accepting new patients
Heritage Behavioral Health Center Inc. Past Accepting new patients
Heritage Behavioral Health Center, Inc Past Accepting new patients
Heritage Behavioral Health Center, Inc. Past Accepting new patients
Have Dreams PastSince Jan 8, 2025 Accepting new patients
Heritage Behavioral Health Center Inc. Past Accepting new patients
Heritage Behavioral Health Center Past Accepting new patients
Heritage Behavioral Health Center Past Accepting new patients
Heritage Behavioral Health Center, Inc Past Accepting new patients
Heritage Behavioral Health Center Inc. Past Accepting new patients
Heritage Behavioral Health Center Past Accepting new patients

Locations

140 Sunrise Ct
Clinton, IL 61727
Phone (217) 570-0900

2965 N Main St
Decatur, IL 62526
Phone (217) 464-1250

788 E Clay St
Decatur, IL 62521

243 W Cerro Gordo St
Decatur, IL 62522
Phone (217) 422-3940

151 N Main St
Decatur, IL 62523
Phone (217) 420-4776

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1801505151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 N MAIN ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625231206",
            "telephone_number": "172-362-6262",
            "fax_number": "217-362-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N MAIN ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625231206",
            "telephone_number": "172-362-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "CARLA",
        "middle_name": "MARIA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.018104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.