| Heritage Behavioral Health Center Inc. | |
|
151 N Main Street Decatur IL 62523 | |
| (217) 362-6262 | |
| (217) 362-6290 |
| Full Name | Heritage Behavioral Health Center Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 151 N Main Street, Decatur, Illinois |
| Authorized Official Name and Position | Mary Garrison (CEO) |
| Authorized Official Contact | 2173626262 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Behavioral Health Center Inc. Po Box 710 Decatur IL 62525 Ph: (217) 362-6262 | Heritage Behavioral Health Center Inc. 151 N Main Street Decatur IL 62523 Ph: (217) 362-6262 |
| NPI Number | 1639231731 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 05/13/2023 |
| Certification Date | 08/13/2021 |
| Medicare PECOS PAC ID | 0547208951 |
|---|---|
| Medicare Enrollment ID | O20050418000456 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639231731 | NPI | - | NPPES |
| Provider Name | Rohidas T Patil |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871601989 PECOS PAC ID: 6800854092 Enrollment ID: I20041220000724 |
| Provider Name | Mary E Garrison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598073959 PECOS PAC ID: 5395900047 Enrollment ID: I20120629000535 |
| Provider Name | Jessica Lynn Lofu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255739645 PECOS PAC ID: 8426371063 Enrollment ID: I20150106001702 |
| Provider Name | Christina E Ventimiglia-brandt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336522275 PECOS PAC ID: 8123315033 Enrollment ID: I20160921000259 |
| Provider Name | Nathalie K Rade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104374727 PECOS PAC ID: 2860778651 Enrollment ID: I20170410001898 |
| Provider Name | Maria Josephine Mynatt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497877880 PECOS PAC ID: 4688957004 Enrollment ID: I20190104000716 |
| Provider Name | Elise Wessol |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972984698 PECOS PAC ID: 8426355231 Enrollment ID: I20191030002836 |
| Provider Name | Rachelle L Born |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952870453 PECOS PAC ID: 6406289040 Enrollment ID: I20191212000357 |
| Provider Name | Megan F Carter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578032686 PECOS PAC ID: 3375979651 Enrollment ID: I20200204002995 |
| Provider Name | Abdullah Bin Mahfodh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033640198 PECOS PAC ID: 3577833094 Enrollment ID: I20210303002734 |
| Provider Name | Matya Leann Riley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013541143 PECOS PAC ID: 3274949698 Enrollment ID: I20210310001324 |
| Provider Name | Sara J Tharp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932678422 PECOS PAC ID: 6204225493 Enrollment ID: I20211109002282 |
| Provider Name | Andrea L Mccoy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891318218 PECOS PAC ID: 4981097391 Enrollment ID: I20220208001073 |
| Provider Name | Sara Cothern |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205527058 PECOS PAC ID: 4486011517 Enrollment ID: I20230606001191 |
| Provider Name | Sian Rankin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295432078 PECOS PAC ID: 9537526587 Enrollment ID: I20230606002303 |
| Provider Name | Maria Nation |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265015226 PECOS PAC ID: 2668826819 Enrollment ID: I20230921004091 |
| Provider Name | Ashley M Garner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205309267 PECOS PAC ID: 0042665333 Enrollment ID: I20231005002709 |
| Provider Name | Dayle Rebelsky |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285331066 PECOS PAC ID: 8022451699 Enrollment ID: I20240210000534 |
| Provider Name | Jasmine M Kaylor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053934471 PECOS PAC ID: 9931542545 Enrollment ID: I20240212001097 |
| Provider Name | Samantha Carroll |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629830211 PECOS PAC ID: 0244674182 Enrollment ID: I20240219001762 |
| Provider Name | Rebekah Harrelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679263446 PECOS PAC ID: 7517302417 Enrollment ID: I20240301001757 |
| Provider Name | Carrie A Ray |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003035254 PECOS PAC ID: 3274979919 Enrollment ID: I20240315002318 |
A & E Behavioral Health Care Associates Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2570 Federal Drive, Decatur, IL 62526 Phone: 217-872-1003 Fax: 217-233-4150 | |
Heritage At Garfield Montessori School Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 Meadow Terrace Pl, Decatur, IL 62521 Phone: 217-362-6262 Fax: 217-362-6290 | |
J & J Maupin Enterprises Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5310 E William Street Rd, Decatur, IL 62521 Phone: 217-422-6361 Fax: 217-422-6365 | |
Heritage At Stephen Decatur Middle School Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Educational Park, Decatur, IL 62526 Phone: 217-362-6262 Fax: 217-362-6290 | |
Heritage At Eisenhower High School Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 S 16th St, Decatur, IL 62521 Phone: 217-362-6262 Fax: 217-362-6290 | |
Decatur Psychological Associates Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3040 N University Ave, Suite 2, Decatur, IL 62526 Phone: 217-872-1700 Fax: 217-872-1366 | |
Cathy Ahlrich Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 345 E Ash Ave Ste A, Decatur, IL 62526 Phone: 217-872-1003 Fax: 217-233-4150 |