Healthcare Provider Details

I. General information

NPI: 1174241897
Provider Name (Legal Business Name): SERENY SADLER MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SERENY MATHIS MA

II. Dates (important events)

Enumeration Date: 08/18/2022
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17197 N LAUREL PARK DR STE 110
LIVONIA MI
48152-7909
US

IV. Provider business mailing address

17197 N LAUREL PARK DR STE 110
LIVONIA MI
48152-7909
US

V. Phone/Fax

Practice location:
  • Phone: 734-744-7252
  • Fax:
Mailing address:
  • Phone: 734-744-7252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number6361008368
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: