Healthcare Provider Details
I. General information
NPI: 1750245965
Provider Name (Legal Business Name): SERENITY COUNSELING GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1212 FLEMINGTOWN RD
HENDERSON NC
27537-3226
US
IV. Provider business mailing address
1212 FLEMINGTOWN RD
HENDERSON NC
27537-3226
US
V. Phone/Fax
- Phone: 443-962-2479
- Fax:
- Phone: 443-962-2479
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHAWNTAY
THERESA
FENYO WOODS
Title or Position: OWNER
Credential: LCMHC
Phone: 443-962-2479