Provider Demographics
NPI:1912444332
Name:DR. DANIELLE DESANTIS & ASSOCIATES, INC
Entity Type:Organization
Organization Name:DR. DANIELLE DESANTIS & ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:DESANTIS
Authorized Official - Suffix:
Authorized Official - Credentials:CP, LMFT
Authorized Official - Phone:401-371-0223
Mailing Address - Street 1:480 NE 31ST ST UNIT 3102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-4592
Mailing Address - Country:US
Mailing Address - Phone:401-371-0223
Mailing Address - Fax:401-217-3612
Practice Address - Street 1:480 NE 31ST ST UNIT 3102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-4592
Practice Address - Country:US
Practice Address - Phone:401-371-0223
Practice Address - Fax:401-217-3612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC0700X, 261QM1300X
RILSW02386104100000X
RIMFT00144106H00000X
RIMFT00055106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1174724322OtherINDIVIDUAL NPI