Healthcare Provider Details

I. General information

NPI: 1003741059
Provider Name (Legal Business Name): SERENE MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 E DOUGLAS AVE
FORT WAYNE IN
46802-3542
US

IV. Provider business mailing address

605 E DOUGLAS AVE
FORT WAYNE IN
46802-3542
US

V. Phone/Fax

Practice location:
  • Phone: 260-494-2481
  • Fax:
Mailing address:
  • Phone: 260-494-2481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ALEXIS CHAPMAN
Title or Position: PMHNP- BC
Credential:
Phone: 260-494-2481