Dale Edward Decker, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6789-123 Issued in WI

Practice address

401 Wisconsin Ave
Madison, WI 53703-1487

Phone

(608) 345-1349

Fax

(608) 256-5116

NPI assigned

Mar 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Moontree Psychotherapy Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, WI
  • NPI 1770806259
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1609993468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 WISCONSIN AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537031487",
            "telephone_number": "608-345-1349",
            "fax_number": "608-256-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 WISCONSIN AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537031487",
            "telephone_number": "608-345-1349",
            "fax_number": "608-256-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "DALE",
        "middle_name": "EDWARD",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-24",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "11475-132",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "6789-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40931200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Nicole Decarlo, MA, CF-SLP
• Judith Decato, RN
• Kira Linnea December, OTR/L
• Haley Decero, NP
• Catherine Ann Decker
• Marissa Decker, M.D.
• Marquita R Decker, M.D., M.P.H.
• Mary Catherine Decker, DDS
• Stephanie Decker, RBT
• Sydney Decker

• Clinical Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.