Individual provider · Type 1 NPI

Tracy Pulliam, LCSW

Clinical Social Worker · Decatur, IL

NPI number 1639458623 Active

Practice location

1900 E Lake Shore Dr, Suite 201
Decatur, IL 62521-3824

Call (217) 422-0027 Map

Fax (217) 422-0041

Mailing address

1508 878th St
Mount Pulaski, IL 62548-6569

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X149011563 (IL)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1639458623

Tracy Pulliam, LCSW's National Provider Identifier is 1639458623, issued on Aug 9, 2011. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Decatur, IL. The record was last updated on Sep 14, 2016.