Mr Jerry Lynn Douglas, LCSW is a
Social Worker - Clinical physician based in Decatur, Illinois. Mr Jerry Lynn Douglas is licensed to practice in * (Not Available) (license number ) and his current practice location is 1770 E Lakeshore Dr, Suite 209, Decatur, Illinois. He can be reached at his office (for appointments etc.) via phone at
(217) 423-6500.
NPI number for Mr Jerry Lynn Douglas is 1841394939 and his current mailing address is 1770 E Lakeshore Dr, Suite 209, Decatur, Illinois. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1841394939.
Physician's Profile
| Full Name | Mr Jerry Lynn Douglas |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 1770 E Lakeshore Dr, Decatur, Illinois |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1841394939
- Provider Enumeration Date: 09/11/2006
- Last Update Date: 02/11/2021
Medical Identifiers
Medical identifiers for Mr Jerry Lynn Douglas such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1841394939 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 149011257 (Illinois) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jerry Lynn Douglas is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Jerry Lynn Douglas, LCSW
1770 E Lakeshore Dr, Suite 209,
Decatur, IL 62521
Ph: (217) 423-6500 | Mr Jerry Lynn Douglas, LCSW
1770 E Lakeshore Dr, Suite 209,
Decatur, IL 62521
Ph: (217) 423-6500 |
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