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General NPI Number Information
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NPI Number | 1457229221
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Entity Type | Individual
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Provider Name | AUTUMN DECKER MA
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Gender | Female
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Dates
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Enumeration Date | 10/24/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 165 N VILLAGE AVE STE 132
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570
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Country | US
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Telephone | 516-350-8564
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Fax |
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Provider Business Mailing Address
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Address Line | 5012 MORENCI LN
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City | LITTLE NECK
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State | NY
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Zip | 11362-1332
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Country | US
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Telephone | 347-287-5675
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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