Basic Information
Provider Information
NPI: 1356493050
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DECKER
FirstName: CATHY
MiddleName: JO
NamePrefix: MS.
NameSuffix:  
Credential: BA, MHP, CD, AAC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MOONEY
OtherFirstName: CATHY
OtherMiddleName: JO
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 1600 E OLIVE ST
Address2: SOUND MENTAL HEALTH
City: SEATTLE
State: WA
PostalCode: 981222735
CountryCode: US
TelephoneNumber: 2063022200
FaxNumber: 2063022210
Practice Location
Address1: 1600 E OLIVE ST
Address2: SOUND MENTAL HEALTH
City: SEATTLE
State: WA
PostalCode: 981222735
CountryCode: US
TelephoneNumber: 2063022200
FaxNumber: 2063022210
Other Information
ProviderEnumerationDate: 01/16/2007
LastUpdateDate: 12/19/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XCG60147988WAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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