MEDICARE: SERENITY CHANTELLE WARD

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
1	106S00000X	Behavior Technician		NC

General Provider Information

NPI Number	:	1689501892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERENITY CHANTELLE WARD

Provider Business Mailing Address
First Line	:	5721 LEVEL RUN RD
Second Line	:
City	:	LONG ISLAND
State	:	VA
Zip	:	24569-2237
Country	:	US
Telephone Number	:	434-303-1170
Fax Number	:

Provider Business Practice Location Address
First Line	:	1130 RIDGE RD
Second Line	:
City	:	MARTINSVILLE
State	:	VA
Zip	:	24112-3206
Country	:	US
Telephone Number	:	434-303-1170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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Directions to “ SERENITY CHANTELLE WARD ” Practice Location

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