Healthcare Provider Details

I. General information

NPI: 1174135529
Provider Name (Legal Business Name): SERENITY COUNSELING & SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7875 NW 57TH ST UNIT 25708
TAMARAC FL
33320-8438
US

IV. Provider business mailing address

7875 NW 57TH ST UNIT 25708
TAMARAC FL
33320-8438
US

V. Phone/Fax

Practice location:
  • Phone: 754-232-6768
  • Fax:
Mailing address:
  • Phone: 754-232-6768
  • Fax:

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 Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY WHYTE
Title or Position: OWNER
Credential:
Phone: 754-232-6768