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General NPI Number Information
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NPI Number | 1144944653
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Entity Type | Organization
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Legal Business Name | DESHEA SANDLES, LCSW, LLC
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Dates
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Enumeration Date | 09/28/2022
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 3122 MAHAN DR STE 801-203
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City | TALLAHASSEE
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State | FL
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Zip | 32308-2500
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Country | US
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Telephone | 850-901-0789
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Fax |
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Provider Business Mailing Address
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Address Line | 3122 MAHAN DR STE 801-203
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City | TALLAHASSEE
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State | FL
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Zip | 32308-2500
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Country | US
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Telephone | 850-901-0789
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER/OWN
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Name | DESHEA SANDLES
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Credential | LCSW
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Telephone | 850-459-3155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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