Desantis, Brian W

Desantis, Brian W is an individual health care provider with primary practice located at 2828 International Cir Suite 140, Colorado Springs CO 80910-3127. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as his primary health care specialty. Desantis, Brian W can be contacted via phone (719) 632-5700.

Contact Information

Primary practice address
2828 International Cir Suite 140 Colorado Springs CO 80910-3127
Phone: (719) 632-5700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 2690 Colorado

Profile Details

NPI number 1861479024
LBN Legal business name Desantis, Brian W
Credentials PSY.D,
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2005
Last updated Apr 3rd, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861479024 NPPES
Colorado MEDICAID 64456722
Colorado Other COA101696

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