Healthcare Provider Details

I. General information

NPI: 1578142642
Provider Name (Legal Business Name): DESIE'S PLACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 W SILVER SPRINGS BLVD UNIT 6
OCALA FL
34475-5647
US

IV. Provider business mailing address

5415 NW 3RD ST
OCALA FL
34482-7505
US

V. Phone/Fax

Practice location:
  • Phone: 352-234-4187
  • Fax:
Mailing address:
  • Phone: 352-234-4187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JULIA COLLMAN
Title or Position: OWNER
Credential:
Phone: 352-234-4187