Healthcare Provider Details

I. General information

NPI: 1043140130
Provider Name (Legal Business Name): SEREIN WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7173 S HAVANA ST
CENTENNIAL CO
80112-3891
US

IV. Provider business mailing address

275 INTERSTATE NORTH CIR SE STE 200
ATLANTA GA
30339-2561
US

V. Phone/Fax

Practice location:
  • Phone: 720-794-8194
  • Fax:
Mailing address:
  • Phone: 720-794-8194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SONATA POON
Title or Position: NURSE PRACTITIONER
Credential: FNP-BC, PMHNP-BC
Phone: 720-794-8194