Provider Demographics
NPI:1790552693
Name:DECKER, JULIA GRACE (LPC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:GRACE
Last Name:DECKER
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 1:1943 E CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-1301
Mailing Address - Country:US
Mailing Address - Phone:203-300-6467
Mailing Address - Fax:
Practice Address - Street 1:120 VALLEY GREEN LN STE 660
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2079
Practice Address - Country:US
Practice Address - Phone:888-227-3898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC016539101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health