Individual
CONNIE DECKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
LAWRENCE COUNTY HEALTH DEPARTMENT BEHAVIOR HEALTH, 11020 STATE ROUTE 250, LAWRENCEVILLE, IL 62439
(618) 943-3754
(618) 943-3657
Mailing address
P.O. BOX 516, LAWRENCEVILLE, IL 62439
(618) 943-3302
(618) 943-7589
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3760061789008
—
IL
Enumeration date
06/26/2019
Last updated
06/26/2019
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