Provider Demographics
NPI:1750328977
Name:DECKNER-GLICK, DAVID H (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:H
Last Name:DECKNER-GLICK
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:707 WHITLOCK AVE SW STE G6
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-4653
Mailing Address - Country:US
Mailing Address - Phone:770-331-8760
Mailing Address - Fax:678-581-0146
Practice Address - Street 1:707 WHITLOCK AVE SW STE G6
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-4653
Practice Address - Country:US
Practice Address - Phone:770-331-8760
Practice Address - Fax:770-977-3634
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0027321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical