Provider Demographics
NPI:1073713954
Name:DECKER, JEREMY E
Entity Type:Individual
Prefix:MR
First Name:JEREMY
Middle Name:E
Last Name:DECKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8670 W 78TH PL
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-4314
Mailing Address - Country:US
Mailing Address - Phone:720-980-3533
Mailing Address - Fax:
Practice Address - Street 1:1395 S PLATTE RIVER DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223-3467
Practice Address - Country:US
Practice Address - Phone:303-871-7080
Practice Address - Fax:303-282-4204
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health