Provider Demographics
NPI:1730383415
Name:ANDES, DESIREE MICHELLE (MA, LMHC, NCC)
Entity type:Individual
Prefix:MS
First Name:DESIREE
Middle Name:MICHELLE
Last Name:ANDES
Suffix:
Gender:F
Credentials:MA, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 RIDGEWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-8811
Mailing Address - Country:US
Mailing Address - Phone:321-720-9378
Mailing Address - Fax:
Practice Address - Street 1:12629 HWY 27
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-8588
Practice Address - Country:US
Practice Address - Phone:407-725-0012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 9060101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health