Healthcare Provider Details

I. General information

NPI: 1548136583
Provider Name (Legal Business Name): DECATUR COUNSELING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3040 N UNIVERSITY AVE STE 2
DECATUR IL
62526-1393
US

IV. Provider business mailing address

3040 N UNIVERSITY AVE STE 2
DECATUR IL
62526-1393
US

V. Phone/Fax

Practice location:
  • Phone: 217-872-1700
  • Fax: 217-872-1366
Mailing address:
  • Phone: 217-872-1700
  • Fax: 217-872-1366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. PAMELA S BURKHART
Title or Position: OWNER/DIRECTOR
Credential: LCSW
Phone: 217-855-7856