Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jerry Lynn Douglas, LCSW

Individual provider Psychiatry Physician · NPI 1841394939

Mr. Jerry Lynn Douglas, LCSW is a Psychiatry Physician in Decatur, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

1770 E Lakeshore Dr Ste 209
Decatur, IL 62521
Phone: (217) 423-6500
Fax: (217) 423-6536
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X
Psychiatry Physician Taxonomy 2084P0800X · Licence 149011257 (IL)

Record details

NPI number1841394939
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedSeptember 11, 2006
Last updated in NPPESFebruary 11, 2021
Certification dateFebruary 11, 2021

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