Active NPI
Nathanael Desantana, MS
- Mental Health Counselor
- Wayne, PA
National Provider Identifier
1982340618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 987 Old Eagle Rd Ste 719
Wayne, PA 19087-1708 - Phone
- (610) 999-6414
- NPI assigned
- May 6, 2022
- Last updated
- May 18, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | PA | Primary |
Addresses
Primary practice location
987 Old Eagle Rd Ste 719
Wayne, PA 19087-1708
Mailing address
2101 Solly Ave
Philadelphia, PA 19152-2816
Phone (215) 908-8973
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Counseling LLC | Mental Health | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652832000000",
"number": "1982340618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 SOLLY AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191522816",
"telephone_number": "215-908-8973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "987 OLD EAGLE RD STE 719",
"city": "WAYNE",
"state": "PA",
"postal_code": "190871708",
"telephone_number": "610-999-6414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESANTANA",
"first_name": "NATHANAEL",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-05-06",
"last_updated": "2022-05-18",
"certification_date": "2022-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "PA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayne, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.