Healthcare Provider Details

I. General information

NPI: 1609635465
Provider Name (Legal Business Name): SERENE AND FEARLESS COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2024
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 SOLANO AVE APT 304
HOLLYWOOD FL
33024-3787
US

IV. Provider business mailing address

2950 SOLANO AVE APT 304
HOLLYWOOD FL
33024-3787
US

V. Phone/Fax

Practice location:
  • Phone: 305-879-7601
  • Fax:
Mailing address:
  • Phone: 305-879-7601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: JAVIER ALEJANDRO COSME
Title or Position: AMBR
Credential: LMHC
Phone: 305-879-7601