Provider Demographics
NPI:1366305625
Name:DESANTIS, PAULA J (LPC)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:J
Last Name:DESANTIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 S ALMA SCHOOL RD STE A206
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3066
Mailing Address - Country:US
Mailing Address - Phone:480-799-9050
Mailing Address - Fax:480-717-4025
Practice Address - Street 1:1930 S ALMA SCHOOL RD STE A206
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3066
Practice Address - Country:US
Practice Address - Phone:480-799-9050
Practice Address - Fax:480-717-4025
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-04
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-24366101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty