Healthcare Provider Details

I. General information

NPI: 1811405376
Provider Name (Legal Business Name): SERENITY FAMILY COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2018
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 20TH SOUTH ST
NEW ULM MN
56073-2223
US

IV. Provider business mailing address

PO BOX 12
NEW ULM MN
56073-0012
US

V. Phone/Fax

Practice location:
  • Phone: 507-338-5600
  • Fax: 888-338-6234
Mailing address:
  • Phone: 507-338-5600
  • Fax: 888-338-6234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number22782
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JAN MARIE SCHWARZROCK
Title or Position: OUTPATIENT THERAPIST
Credential: MSW, LICSW, RPT
Phone: 507-338-5600