Active NPI
Justin Michael Decker, LGSW
- Social Worker
- Havre de Grace, MD
National Provider Identifier
1083975445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 17944
- Practice address
- 626 Revolution Street
Havre de Grace, MD 21078 - Phone
- (410) 939-8744
- NPI assigned
- Jun 1, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 17944 | MD | Primary |
Addresses
Primary practice location
626 Revolution Street
Havre de Grace, MD 21078
Mailing address
626 Revolution Street
Havre de Grace, MD 21078
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17944 | MD | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338508800000",
"number": "1083975445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "626 REVOLUTION STREET",
"city": "HAVRE DE GRACE",
"state": "MD",
"postal_code": "21078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "626 REVOLUTION STREET",
"city": "HAVRE DE GRACE",
"state": "MD",
"postal_code": "21078",
"telephone_number": "410-939-8744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECKER",
"first_name": "JUSTIN",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "LGSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-01",
"last_updated": "2012-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "17944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Havre de Grace, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.