Provider Demographics
NPI:1881195568
Name:DESIRE WELLNESS, LLC
Entity Type:Organization
Organization Name:DESIRE WELLNESS, LLC
Other - Org Name:DESIRE WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI-ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:SARNOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:508-245-0606
Mailing Address - Street 1:4 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MEDWAY
Mailing Address - State:MA
Mailing Address - Zip Code:02053-1680
Mailing Address - Country:US
Mailing Address - Phone:508-245-0606
Mailing Address - Fax:
Practice Address - Street 1:2 KINGSON LN UNIT 6
Practice Address - Street 2:
Practice Address - City:MEDWAY
Practice Address - State:MA
Practice Address - Zip Code:02053-6154
Practice Address - Country:US
Practice Address - Phone:508-245-0606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1030953251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health