Provider Demographics
NPI:1326786419
Name:DECKLING, HOLLY (LISW)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:DECKLING
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3395 DEMPSEY RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-3901
Mailing Address - Country:US
Mailing Address - Phone:740-972-4878
Mailing Address - Fax:
Practice Address - Street 1:5027 PINE CREEK DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-4849
Practice Address - Country:US
Practice Address - Phone:614-306-1474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.22036601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical