Healthcare Provider Details

I. General information

NPI: 1972889442
Provider Name (Legal Business Name): SERENITY COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2011
Last Update Date: 10/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 ST ANTHONY STREET
ANTHONY NM
88021
US

IV. Provider business mailing address

PO BOX 13794
LAS CRUCES NM
88013-3794
US

V. Phone/Fax

Practice location:
  • Phone: 575-649-9327
  • Fax: 575-382-0909
Mailing address:
  • Phone: 575-649-9327
  • Fax: 575-382-0909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0129221
License Number State

VIII. Authorized Official

Name: ANASTASIA LYNN ALBERT
Title or Position: CLINICAL DIRECTOR
Credential:
Phone: 575-649-9327