Healthcare Provider Details

I. General information

NPI: 1154234276
Provider Name (Legal Business Name): DESIRED CHANGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8008 E ARAPAHOE CT # 103
CENTENNIAL CO
80112-6839
US

IV. Provider business mailing address

582 NILE ST
AURORA CO
80010-4732
US

V. Phone/Fax

Practice location:
  • Phone: 504-510-1447
  • Fax:
Mailing address:
  • Phone: 720-689-3512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALEXIS TOUSSAINT
Title or Position: OWNER/CEO
Credential: DSW, LCSW
Phone: 504-510-1447