Provider Demographics
NPI:1003089046
Name:DECKER, BARBARA BRUNDIGE (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:BRUNDIGE
Last Name:DECKER
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 N. ABINGTON RD.
Mailing Address - Street 2:PO BOX 246
Mailing Address - City:WAVERLY
Mailing Address - State:PA
Mailing Address - Zip Code:18471
Mailing Address - Country:US
Mailing Address - Phone:570-563-2395
Mailing Address - Fax:570-563-2477
Practice Address - Street 1:1318 N. ABINGTON RD.
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:PA
Practice Address - Zip Code:18471
Practice Address - Country:US
Practice Address - Phone:570-563-2395
Practice Address - Fax:570-563-2477
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000233101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional