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General NPI Number Information
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NPI Number | 1538607213
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Entity Type | Organization
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Legal Business Name | DR. DESANTIS & ASSOCIATES
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 1500 PONTIAC AVE STE 101
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City | CRANSTON
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State | RI
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Zip | 02920-4486
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Country | US
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Telephone | 401-371-0223
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Fax | 401-464-4071
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Provider Business Mailing Address
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Address Line | 14 ZENITH DR
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City | CRANSTON
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State | RI
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Zip | 02920-4441
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Country | US
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Telephone | 401-419-0627
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Fax | 401-464-4071
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. DANIELLE DESANTIS
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Credential | PSYD, LMFT
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Telephone | 401-371-0223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LSW02386
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LSW02451
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT00055
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License Number State | RI
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 00144
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License Number State | RI
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