Healthcare Provider Details

I. General information

NPI: 1245162718
Provider Name (Legal Business Name): SERENITY MENTAL WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 BROOKHAVEN DR
CLAYTON NC
27527-6282
US

IV. Provider business mailing address

198 BROOKHAVEN DR
CLAYTON NC
27527-6282
US

V. Phone/Fax

Practice location:
  • Phone: 516-661-2727
  • Fax:
Mailing address:
  • Phone: 516-661-2727
  • 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: MRS. KRISTA NIKIA KHALIK
Title or Position: MSN, APRN, PMHNP-BC
Credential: PMHNP-BC
Phone: 516-661-2727