Provider Demographics
NPI:1073926960
Name:DECECCHIS, CARA (LPC)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:DECECCHIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-1470
Mailing Address - Country:US
Mailing Address - Phone:267-907-4007
Mailing Address - Fax:
Practice Address - Street 1:623 W MARKET ST
Practice Address - Street 2:
Practice Address - City:PERKASIE
Practice Address - State:PA
Practice Address - Zip Code:18944-1470
Practice Address - Country:US
Practice Address - Phone:267-907-4007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007648101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional