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Thomas Jay Decker I
Peer Specialist in Ticonderoga, New York
NPI 1437883709

Thomas Jay Decker I is a Peer Specialist based in Ticonderoga, NY. Thomas Jay Decker I practices in Ticonderoga, NY. The NPI Number for Thomas Jay Decker I is 1437883709 and holds a License No. (New York).

The current practice location address for Thomas Jay Decker I is 50 Montcalm St, Ticonderoga, NY and can be reached out via phone at 518-585-7934 and via fax at 518-585-9132.

Location: 50 Montcalm St, Ticonderoga, NY, 12883-1393
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1437883709
Provider Name
Thomas Jay Decker I
Credential
Provider Entity Type
Individual
Gender
Male
Address
50 Montcalm St, Ticonderoga, NY, 12883-1393
Phone Number
518-585-7934
Fax Number
518-585-9132
Provider Enumeration Date
07/13/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1629172762 05 NY
institution
Provider Business Practice Location Address Details
Address
50 Montcalm St
City
Ticonderoga
State
New York
Zip
12883-1393
Phone Number
518-585-7934
Fax Number
518-585-9132
person
Provider Business Mailing Address Details
Address
50 Montcalm St
City
Ticonderoga
State
New York
Zip
12883-1393
Phone Number
518-585-7934
Fax Number
518-585-9132
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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