Healthcare Provider Details

I. General information

NPI: 1801454897
Provider Name (Legal Business Name): SERENITY COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2019
Last Update Date: 06/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 VALLEY ST
CUMBERLAND MD
21502-2141
US

IV. Provider business mailing address

118 VALLEY ST
CUMBERLAND MD
21502-2141
US

V. Phone/Fax

Practice location:
  • Phone: 301-722-5500
  • Fax: 301-722-0500
Mailing address:
  • Phone: 301-722-5500
  • Fax: 301-722-0500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. DONNA RICE
Title or Position: OWNER/PROVIDER
Credential: LCSW-C,MAC,ADS
Phone: 301-722-5500