MR. GERALD ERIC DECKELBAUM LCSW NPI 1336235126

NPI Information

  • NPI: 1336235126
  • Provider Name: MR. GERALD ERIC DECKELBAUM, LCSW
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1020 SW TAYLOR ST
    #445
    PORTLAND, OR
    ZIP 97205
  • Phone: (503) 224-0033

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NPI Details

MR. Gerald Eric Deckelbaum, LCSW is a mental health counselor in Portland, OR. MR. Gerald Eric Deckelbaum, LCSW NPI is 1336235126. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1020 SW TAYLOR ST
#445
PORTLAND, OR
ZIP 97205-543
Phone: (503) 224-0033

The NPI 1336235126 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 10/5/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental Health2999OREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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