Healthcare Provider Details

I. General information

NPI: 1124948427
Provider Name (Legal Business Name): JUSTINE LEE DECKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 N LOUISIANA AVE STE D4
ASHEVILLE NC
28806-3641
US

IV. Provider business mailing address

226 BRICKYARD RD UNIT C
ASHEVILLE NC
28806-2815
US

V. Phone/Fax

Practice location:
  • Phone: 863-517-8333
  • Fax:
Mailing address:
  • Phone: 863-517-8333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCADC-30518
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: