Healthcare Provider Details

I. General information

NPI: 1497659445
Provider Name (Legal Business Name): DEANNA DECKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 WALL ST
KINGSTON NY
12401-4809
US

IV. Provider business mailing address

746 STATE ROUTE 44 55
HIGHLAND NY
12528-2293
US

V. Phone/Fax

Practice location:
  • Phone: 845-233-5935
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP144289
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: