Provider Demographics
NPI:1699567008
Name:DECKER, KATHRYN M (MS, CAGS)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:M
Last Name:DECKER
Suffix:
Gender:F
Credentials:MS, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1463 BEACON ST APT 32
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-4717
Mailing Address - Country:US
Mailing Address - Phone:518-937-3057
Mailing Address - Fax:
Practice Address - Street 1:173 SALEM ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02113-1206
Practice Address - Country:US
Practice Address - Phone:518-937-3057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool