Individual provider · Type 1 NPI

Timothy Stephen Desantis, LCPC

Addiction (Substance Use Disorder) Counselor · Boise, ID

NPI number 1861837601 Active

Practice location

8620 W Emerald St, Suite 150
Boise, ID 83704-4824

Fax (208) 672-2919

Mailing address

1410 Chelsey Cir
Mountain Home, ID 83647-4634

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XLCPC-4671 (ID)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1861837601

Timothy Stephen Desantis, LCPC's National Provider Identifier is 1861837601, issued on May 7, 2013. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Boise, ID. The record was last updated on May 7, 2013.