Healthcare Provider Details

I. General information

NPI: 1194681007
Provider Name (Legal Business Name): MOTHERHOOD WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 GWYNNE RD
FRANKLIN MA
02038-3301
US

IV. Provider business mailing address

9 GWYNNE RD
FRANKLIN MA
02038-3301
US

V. Phone/Fax

Practice location:
  • Phone: 860-874-1976
  • Fax:
Mailing address:
  • Phone: 860-874-1976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE KORNACKI
Title or Position: PRACTICE OWNER
Credential: LMHC
Phone: 860-874-1976