Provider Demographics
NPI:1134508013
Name:DESANTI, JAMILYN LOUISE (MHP, BS)
Entity Type:Individual
Prefix:MRS
First Name:JAMILYN
Middle Name:LOUISE
Last Name:DESANTI
Suffix:
Gender:F
Credentials:MHP, BS
Other - Prefix:MS
Other - First Name:JAMILYN
Other - Middle Name:LOUISE
Other - Last Name:SMOLIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11447 2ND ST STE 9B
Mailing Address - Street 2:
Mailing Address - City:ROSCOE
Mailing Address - State:IL
Mailing Address - Zip Code:61073-9522
Mailing Address - Country:US
Mailing Address - Phone:608-290-6705
Mailing Address - Fax:630-892-0027
Practice Address - Street 1:11447 2ND ST.
Practice Address - Street 2:#96
Practice Address - City:ROSCOE
Practice Address - State:IL
Practice Address - Zip Code:61073
Practice Address - Country:US
Practice Address - Phone:815-601-4673
Practice Address - Fax:866-303-8062
Is Sole Proprietor?:No
Enumeration Date:2015-05-25
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor