Provider Demographics
NPI:1073377990
Name:SEVAN SERENITY PSYCH AND WELLNESS LLC
Entity Type:Organization
Organization Name:SEVAN SERENITY PSYCH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADOM
Authorized Official - Middle Name:LOUTFI
Authorized Official - Last Name:FERMANIAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:508-505-8830
Mailing Address - Street 1:45 EASTMAN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375-2600
Mailing Address - Country:US
Mailing Address - Phone:508-505-8830
Mailing Address - Fax:
Practice Address - Street 1:45 EASTMAN ST
Practice Address - Street 2:
Practice Address - City:SOUTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02375-2600
Practice Address - Country:US
Practice Address - Phone:508-505-8830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health