Healthcare Provider Details

I. General information

NPI: 1508682931
Provider Name (Legal Business Name): SERENITY WELLNESS MENTAL HEALTH CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2024
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 FREDERICK RD STE 11
CATONSVILLE MD
21228-4607
US

IV. Provider business mailing address

405 FREDERICK RD STE 11
CATONSVILLE MD
21228-4607
US

V. Phone/Fax

Practice location:
  • Phone: 443-468-4838
  • Fax: 443-281-6333
Mailing address:
  • Phone: 443-468-4838
  • Fax: 443-281-6333

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 StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. CHIAMAKA NNAH
Title or Position: CEO
Credential: CRNP-PMH
Phone: 443-468-4838