Provider Demographics
NPI:1275050510
Name:DECKER, REBECCA M (LCSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:M
Last Name:DECKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11351 PLEASANT KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-6074
Mailing Address - Country:US
Mailing Address - Phone:225-439-0535
Mailing Address - Fax:
Practice Address - Street 1:3801 NORTH BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3825
Practice Address - Country:US
Practice Address - Phone:225-655-6422
Practice Address - Fax:225-341-5903
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA21131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical