Individual provider Active NPI

Andrea L McCoy

  • Clinical Social Worker
  • Decatur, IL
National Provider Identifier
1891318218
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-023281 Issued in IL
Practice address
151 N Main St
Decatur, IL 62523-1206
Phone
(217) 420-4776
Fax
(217) 362-6290
NPI assigned
May 20, 2020
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 150-104132 IL
Clinical Social Worker 1041C0700X 149-023281 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 (217) 420-4776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150-104132ILMDCounselor
149-023281ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Behavioral Health Center Inc. CurrentSince Oct 5, 2021 Accepting new patients
Heritage Behavioral Health Center, Inc. CurrentSince Oct 5, 2021 Accepting new patients
Heritage Behavioral Health Center Inc. 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
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
Heritage Behavioral Health Center Inc. 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 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1891318218",
    "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": "217-420-4776",
            "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": "217-420-4776",
            "fax_number": "217-362-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "ANDREA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "150-104132",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-023281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.