Provider Demographics
NPI:1114567856
Name:SARVA PSYCHOTHERAPY AND WELLNESS LLC
Entity Type:Organization
Organization Name:SARVA PSYCHOTHERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ENAKSHI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOUDHURI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LPCC
Authorized Official - Phone:763-607-1019
Mailing Address - Street 1:3300 PLYMOUTH BLVD # 46294
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-1897
Mailing Address - Country:US
Mailing Address - Phone:612-293-0848
Mailing Address - Fax:
Practice Address - Street 1:10501 WAYZATA BLVD STE 204
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1519
Practice Address - Country:US
Practice Address - Phone:612-293-0848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty