Provider Demographics
NPI:1932159209
Name:DECKER, DWIGHT LEE (LPC)
Entity Type:Individual
Prefix:MR
First Name:DWIGHT
Middle Name:LEE
Last Name:DECKER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 JAMES PL
Mailing Address - Street 2:
Mailing Address - City:HEBER SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72543-7638
Mailing Address - Country:US
Mailing Address - Phone:501-362-3937
Mailing Address - Fax:870-793-6774
Practice Address - Street 1:400 HARRISON ST
Practice Address - Street 2:SUITE 107
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501
Practice Address - Country:US
Practice Address - Phone:501-206-8402
Practice Address - Fax:870-793-6774
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPO510064101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional