Provider Demographics
NPI:1942751318
Name:DECIECHI, AMBER (LMSW)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:DECIECHI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 N CASEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PIGEON
Mailing Address - State:MI
Mailing Address - Zip Code:48755-9704
Mailing Address - Country:US
Mailing Address - Phone:989-453-7301
Mailing Address - Fax:989-453-7306
Practice Address - Street 1:75 BUSCHLEN RD
Practice Address - Street 2:
Practice Address - City:BAD AXE
Practice Address - State:MI
Practice Address - Zip Code:48413-9177
Practice Address - Country:US
Practice Address - Phone:989-623-9300
Practice Address - Fax:989-269-0243
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011000161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical