Healthcare Provider Details

I. General information

NPI: 1528715679
Provider Name (Legal Business Name): SERENITY PSYCHOTHERAPY GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2022
Last Update Date: 12/29/2022
Certification Date: 12/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10604 DRUMM AVE
KENSINGTON MD
20895-2701
US

IV. Provider business mailing address

10604 DRUMM AVE
KENSINGTON MD
20895-2701
US

V. Phone/Fax

Practice location:
  • Phone: 443-877-7440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SARAH CHARMCHI
Title or Position: OWNER
Credential:
Phone: 202-990-2707