Healthcare Provider Details

I. General information

NPI: 1821899634
Provider Name (Legal Business Name): SERENE MIND WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6490 LANDOVER RD STE H
CHEVERLY MD
20785-1443
US

IV. Provider business mailing address

2510 CHESHAIRE DR
BALTIMORE MD
21244-1968
US

V. Phone/Fax

Practice location:
  • Phone: 315-547-0502
  • Fax:
Mailing address:
  • Phone: 315-547-0502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY ADEYEMO
Title or Position: OWNER
Credential:
Phone: 315-547-0502