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General NPI Number Information
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NPI Number | 1558201731
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Entity Type | Individual
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Provider Name | DESIREE VANZANTEN LISW-CP
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Gender | Female
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Dates
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Enumeration Date | 03/30/2026
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Last Update Date | 03/30/2026
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Provider Practice Location Address
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Address Line | 883 NE MAIN ST
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City | SIMPSONVILLE
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State | SC
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Zip | 29681-2051
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Country | US
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Telephone | 864-383-0384
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Fax | 864-568-3938
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Provider Business Mailing Address
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Address Line | 205 FARRS BRIDGE RD
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City | GREENVILLE
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State | SC
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Zip | 29617-1905
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Country | US
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Telephone | 864-383-0384
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Fax | 864-568-3938
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 18657
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License Number State | SC
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