Healthcare Provider Details

I. General information

NPI: 1740975895
Provider Name (Legal Business Name): SERENE BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2069 BANBURY LN
SPRING HILL FL
34609-6014
US

IV. Provider business mailing address

2069 BANBURY LN
SPRING HILL FL
34609-6014
US

V. Phone/Fax

Practice location:
  • Phone: 727-626-2067
  • Fax: 727-380-6287
Mailing address:
  • Phone: 727-626-2067
  • Fax: 727-380-6287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AMANDA SPADAFORA
Title or Position: CEO
Credential:
Phone: 352-942-3824