Provider Demographics
NPI:1740608140
Name:DECUIR, DAVID (MSW,CNP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DECUIR
Suffix:
Gender:M
Credentials:MSW,CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 S PATRICK DR
Mailing Address - Street 2:SUITE 24
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3939
Mailing Address - Country:US
Mailing Address - Phone:321-773-1111
Mailing Address - Fax:321-773-1692
Practice Address - Street 1:1127 S PATRICK DR
Practice Address - Street 2:SUITE 24
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3939
Practice Address - Country:US
Practice Address - Phone:321-773-1111
Practice Address - Fax:321-773-1692
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical