Basic Information
| Provider Information | |||||||||
| NPI: | 1063563005 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DECKER | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | MOLISON | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LCSW-R | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 GATES CIR | ||||||||
| Address2: | 8TH FLOOR | ||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142091120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168875789 | ||||||||
| FaxNumber: | 7168875801 | ||||||||
| Practice Location | |||||||||
| Address1: | 3 GATES CIR | ||||||||
| Address2: | 8TH FLOOR | ||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142091120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168875789 | ||||||||
| FaxNumber: | 7168875801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | R059858-1 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.