Provider Demographics
NPI:1366019739
Name:DESANTE, ALYSSA (LSW)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:DESANTE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 SALSBURY RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1336
Mailing Address - Country:US
Mailing Address - Phone:856-313-7553
Mailing Address - Fax:
Practice Address - Street 1:3 3RD ST
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-1370
Practice Address - Country:US
Practice Address - Phone:609-651-0494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-05
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker