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General NPI Number Information
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NPI Number | 1346422482
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Entity Type | Individual
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Provider Name | ELAINE JOY DECKER M.S., LPC
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Gender | Female
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Dates
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Enumeration Date | 11/30/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 555 MID TOWNE NE SUITE 304 PSYCHOLOGY ASSOCIATES OF GRAND RAPIDS, PC
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City | GRAND RAPIDS
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State | MI
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Zip | 49503
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Country | US
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Telephone | 616-458-4444
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Fax | 616-458-4440
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Provider Business Mailing Address
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Address Line | 1000 PARCHMENT DR, SE PSYCHOLOGY ASSOCIATES OF GRAND RAPIDS, PC
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City | GRAND RAPIDS
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State | MI
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Zip | 49546
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Country | US
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Telephone | 616-957-9112
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Fax | 616-957-2409
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401001566
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License Number State | MI
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