Provider Demographics
NPI:1699427377
Name:KIMBER DECKER COUNSELING AND CONSULTATION PLLC
Entity type:Organization
Organization Name:KIMBER DECKER COUNSELING AND CONSULTATION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO, PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KIMBER
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC
Authorized Official - Phone:616-320-4664
Mailing Address - Street 1:4829 E BELTLINE AVE NE STE 303
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-9350
Mailing Address - Country:US
Mailing Address - Phone:616-320-4664
Mailing Address - Fax:833-469-2110
Practice Address - Street 1:4829 E BELTLINE AVE NE STE 303
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-9350
Practice Address - Country:US
Practice Address - Phone:616-320-4664
Practice Address - Fax:833-469-2110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty