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NPI Code Detail

MEDICARE: SERENITY CHRISTIAN COUNSELING

MEDICARE: SERENITY CHRISTIAN COUNSELING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorE.1800504OH
21041C0700XClinical Social Worker
3101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1316432636
Entity Type Code : Organization
Provider Name (Legal Business Name) : SERENITY CHRISTIAN COUNSELING
Provider Business Mailing Address
First Line : 125 S MAIN ST STE 305
Second Line :
City : FOSTORIA
State : OH
Zip : 44830-2361
Country : US
Telephone Number : 567-249-1000
Fax Number : 419-436-7460
Provider Business Practice Location Address
First Line : 125 S MAIN ST STE 305
Second Line :
City : FOSTORIA
State : OH
Zip : 44830-2361
Country : US
Telephone Number : 567-429-1000
Fax Number : 419-436-7460
Authorized Official
Title or Position : OWNER/CLINICAL DIRECTOR
Name : TECKY ANN RUSK
Credential : LPCC
Telephone Number : 567-429-1000
Provider Enumeration Date : 06/28/2018
Last Update Date : 04/10/2025

Similar Medicare Providers

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1578389912 — SERENITY CHRISTIAN COUNSELING LLC
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44830-2361
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1376369728 — SERENITY CHRISTIAN COUNSELING LLC
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1063391704 — ALISON LEBLANC LPC
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Directions to “SERENITY CHRISTIAN COUNSELING ” Practice Location

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