MEDICARE: SERENITY & STRENGTH COUNSELING, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	171M00000X	Case Manager/Care Coordinator
3	175T00000X	Peer Specialist
4	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1720807696
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY & STRENGTH COUNSELING, LLC

Provider Business Mailing Address
First Line	:	PO BOX 24237
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45424-0237
Country	:	US
Telephone Number	:	937-952-9985
Fax Number	:	937-507-6669

Provider Business Practice Location Address
First Line	:	2775 ORCHARD RUN RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45449-2831
Country	:	US
Telephone Number	:	937-952-9985
Fax Number	:	937-507-6669

Authorized Official
Title or Position	:	OWNER
Name	:	MS. YALANDA LACHELL SMITH-HUDLIN
Credential	:	LPCC-S
Telephone Number	:	937-952-9985

Provider Enumeration Date	:	10/08/2024
Last Update Date	:	10/08/2024

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