Individual
BRIAN DECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
114 GENESEE ST, UTICA, NY 13502-3508
(845) 536-9113
Mailing address
733 DAWES AVE, UTICA, NY 13502-1637
(845) 536-9113
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
007942
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336163963
—
NY
Enumeration date
06/06/2017
Last updated
10/29/2018
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