Individual provider Active NPI

Matthew Eilers Decker, LCSW

  • Mental Health Counselor
  • Suisun City, CA
National Provider Identifier
1386965069
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
83925 Issued in CA
Practice address
333 Sunset Ave Ste 200
Suisun City, CA 94585-2003
Phone
(707) 225-7899
Fax
(707) 759-3810
NPI assigned
Jun 17, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 83925 CA
Case Manager/Care Coordinator 171M00000X
Mental Health Counselor 101YM0800X 83925 CA Primary

Addresses

Primary practice location

333 Sunset Ave Ste 200
Suisun City, CA 94585-2003

Mailing address

333 Sunset Ave Ste 200
Suisun City, CA 94585-2003
Phone (602) 363-3156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201020001497 CA Practitioner - Clinical Social Worker 8820418478

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
E5 TherapyGroup PAC ID 8527478627, 2 clinicians

Practice addresses (Care Compare)

333 Sunset Ave
Suite 200
Suisun City, CA 94585-2003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
83925CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
E5 Therapy Inc. Mental Health CurrentSince Apr 2, 2020 Accepting new patients
E5 Therapy Mental Health CurrentSince Jun 27, 2020 Accepting new patients

Locations

1652 W Texas St
Ste 219
Fairfield, CA 94533
Phone (530) 318-1585

333 Sunset Ave
Ste 110
Suisun City, CA 94585
Phone (707) 225-7899

333 Sunset Ave
Ste 200
Suisun City, CA 94585
Phone (707) 225-7899

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1386965069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SUNSET AVE STE 200",
            "city": "SUISUN CITY",
            "state": "CA",
            "postal_code": "945852003",
            "telephone_number": "602-363-3156",
            "fax_number": "707-759-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SUNSET AVE STE 200",
            "city": "SUISUN CITY",
            "state": "CA",
            "postal_code": "945852003",
            "telephone_number": "707-225-7899",
            "fax_number": "707-759-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "MATTHEW",
        "middle_name": "EILERS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-17",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "83925",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "83925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suisun City, CA

Sources for this page

Verify at the official NPI Registry.