Healthcare Provider Details

I. General information

NPI: 1801755889
Provider Name (Legal Business Name): SERENITY NEURO WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9176 NATHAN CIR
WARRIOR AL
35180-2311
US

IV. Provider business mailing address

9176 NATHAN CIR
WARRIOR AL
35180-2311
US

V. Phone/Fax

Practice location:
  • Phone: 205-383-7384
  • Fax:
Mailing address:
  • Phone: 205-383-7384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AMBER HODGES
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 205-383-7384