Healthcare Provider Details

I. General information

NPI: 1538264783
Provider Name (Legal Business Name): DONNA K DESANTO MSW ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10570 S US HIGHWAY 1 SUITE 200
PORT SAINT LUCIE FL
34952-5606
US

IV. Provider business mailing address

5325 GREENWOOD AVE SUITE 201
WEST PALM BEACH FL
33407-2452
US

V. Phone/Fax

Practice location:
  • Phone: 772-380-9972
  • Fax: 722-380-9976
Mailing address:
  • Phone: 561-881-2822
  • Fax: 561-888-1097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: