Provider Demographics
NPI:1740498922
Name:DESPER, DONALD LYNN (LPC)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:LYNN
Last Name:DESPER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13442 WINDSONG DR
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-5511
Mailing Address - Country:US
Mailing Address - Phone:228-671-0436
Mailing Address - Fax:
Practice Address - Street 1:152 HIGHWAY 7 SOUTH
Practice Address - Street 2:COMMUNICARE
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655
Practice Address - Country:US
Practice Address - Phone:662-234-7521
Practice Address - Fax:662-236-3720
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS971101YP2500X
MS0971101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional