MEDICARE: AMBER DECIECHI LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6801100016	MI

General Provider Information

NPI Number	:	1942751318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER DECIECHI LMSW

Provider Business Mailing Address
First Line	:	170 N CASEVILLE RD
Second Line	:
City	:	PIGEON
State	:	MI
Zip	:	48755-9704
Country	:	US
Telephone Number	:	989-453-7301
Fax Number	:	989-453-7306

Provider Business Practice Location Address
First Line	:	75 BUSCHLEN RD
Second Line	:
City	:	BAD AXE
State	:	MI
Zip	:	48413-9177
Country	:	US
Telephone Number	:	989-623-9300
Fax Number	:	989-269-0243

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2016
Last Update Date	:	05/21/2024

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Directions to “ AMBER DECIECHI LMSW” Practice Location

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