| Elizabeth King Decker, MA, LMFT | |
|
1530 Celebration Blvd Ste 405, Celebration, FL 34747-5165 | |
| (833) 769-3524 | |
| Not Available |
| Full Name | Elizabeth King Decker |
|---|---|
| Gender | Female |
| Speciality | Marriage & Family Therapist |
| Location | 1530 Celebration Blvd Ste 405, Celebration, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477083376 | NPI | - | NPPES |
| 81-509-8610 | Other | CT | IRS INDIVIDUAL TAXPAYER IDENTIFICATION NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 001849 (Connecticut) | Secondary |
| 106H00000X | Marriage & Family Therapist | MT4422 (Florida) | Primary |
| Entity Name | Personal Recovery Network Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881990869 PECOS PAC ID: 5092611384 Enrollment ID: O20200416000590 |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth King Decker, MA, LMFT 7 Cross Ridge Dr, Old Greenwich, CT 06870-1101 Ph: (203) 505-8404 | Elizabeth King Decker, MA, LMFT 1530 Celebration Blvd Ste 405, Celebration, FL 34747-5165 Ph: (833) 769-3524 |
Rachael Ann Haley Smithey, RMFTI Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 1530 Celebration Blvd Ste 405, Celebration, FL 34747 Phone: 833-769-3524 Fax: 321-233-9959 | |
Dr. Richard James Vantrease, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 800 Celebration Ave, Suite 302, Celebration, FL 34747 Phone: 407-566-1815 Fax: 321-939-7606 |