Myna-Anaistazsa Desmarais

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW230236 Issued in MA

Practice address

191 Bedford St
Fall River, MA 02720-3050

Phone

(508) 672-4255

NPI assigned

Sep 5, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: myna-anaistazsa.desmarais@direct.signature.masshiway.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brockton Hospital, Inc.

  • Community/Retail Pharmacy
  • East Bridgewater, MA
  • NPI 1033084462
  NPD
• Brockton Hospital, Inc.

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1063431286
  NPD
• Signature Healthcare Medical Group Inc

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1508804949

  Social Worker

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1922729359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 BEDFORD ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027203050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 BEDFORD ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027203050",
            "telephone_number": "508-672-4255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 Centre St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023023308",
            "country_code": "US",
            "telephone_number": "508-941-7851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESMARAIS",
        "first_name": "MYNA-ANAISTAZSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LCSW230236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Anne Dersham, D.C.
• Jeffrey A. Deschenes
• Iris Y Desena
• Claude Desir
• Jacqueline Marie Desjardins, RN
• Alyssa Jordan Desorcy
• Christine Desousa, LPN
• Roxanne Desousa
• Vanessa Andrade Desousa, COTA/L
• Christopher Desroches

• Clinical Social Worker in Fall River, MA
• Providers in Fall River, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.