Deckel, Albert Wallace

Deckel, Albert Wallace is an sole proprietor health care provider with primary practice located at 382 W Main St Suite 202, Northborough MA 01532-2157. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is his primary health care specialty. Deckel, Albert Wallace can be contacted via phone (508) 393-3820.

Contact Information

Primary practice address
382 W Main St Suite 202 Northborough MA 01532-2157
Phone: (508) 393-3820
Fax: (505) 393-3814
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 8183 Massachusetts
Behavioral Health & Social Service Providers / Psychologist 103T00000X 8183 Massachusetts
Behavioral Health & Social Service Providers / Clinical 103TC0700X 8183 Massachusetts

Profile Details

NPI number 1487652483
LBN Legal business name Deckel, Albert Wallace
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 13th, 2005
Last updated Aug 15th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487652483 NPPES
Massachusetts MEDICAID 0522791

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