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General NPI Number Information
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NPI Number | 1881217206
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Entity Type | Individual
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Provider Name | WILLIAM KEITH JIHAN LCPC
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Gender | Male
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Dates
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Enumeration Date | 05/20/2020
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 151 N MAIN ST
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City | DECATUR
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State | IL
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Zip | 62523-1206
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Country | US
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Telephone | 217-362-6262
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Fax |
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Provider Business Mailing Address
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Address Line | 611 W PARK ST FAPC
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City | URBANA
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State | IL
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Zip | 61801-2500
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180014215
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 178-015547
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180.014215
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License Number State | IL
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