Healthcare Provider Details

I. General information

NPI: 1831961192
Provider Name (Legal Business Name): SERENE JOURNEY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21430 RANDOLPH PL
DENVER CO
80249-8329
US

IV. Provider business mailing address

21430 RANDOLPH PL
DENVER CO
80249-8329
US

V. Phone/Fax

Practice location:
  • Phone: 720-495-7099
  • Fax:
Mailing address:
  • Phone: 720-495-7099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. DENETTE MARTINEZ-GUZMAN
Title or Position: LPC/OWNER
Credential: LPC
Phone: 720-495-7099