Provider Demographics
NPI:1033522081
Name:DECKER, RENEE (LPC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:DECKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:STALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:6851 COURTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-5308
Mailing Address - Country:US
Mailing Address - Phone:804-715-3215
Mailing Address - Fax:804-715-3233
Practice Address - Street 1:6851 COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832
Practice Address - Country:US
Practice Address - Phone:804-715-3215
Practice Address - Fax:804-715-3233
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-07
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005904101YP2500X
OHE.0900326101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional