Timothy Desantis, LCPC

NPI 1861837601 · on the registry since 2013 · sole proprietor

Practice

Address: 8620 W Emerald St
Suite 150
Boise, ID 83704
Phone: (208) 672-2900
Fax: (208) 672-2919
Organisation at this address: Velocity Developmental Center
Primary Behavioral Health Services
Living Independently Forever, Inc.
Living Independently Forever, Inc.
Living Independently Forever, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 56

Registry record

Primary taxonomy: 101YA0400X
101YA0400X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2013-05-07

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho