Healthcare Provider Details

I. General information

NPI: 1083559405
Provider Name (Legal Business Name): SERENE HARBOR PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 STANDISH ST
BRIDGEPORT CT
06610
US

IV. Provider business mailing address

1019 MAIN ST
BRIDGEPORT CT
06604-4221
US

V. Phone/Fax

Practice location:
  • Phone: 332-301-6945
  • Fax:
Mailing address:
  • Phone: 332-301-6945
  • 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: MARSHANIEK WHITE
Title or Position: OWNER
Credential: NP
Phone: 332-301-6945