Healthcare Provider Details

I. General information

NPI: 1114852548
Provider Name (Legal Business Name): SERENE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7465 W LAKE MEAD BLVD STE 225
LAS VEGAS NV
89128-1033
US

IV. Provider business mailing address

4528 STARDUSK FALLS AVE
NORTH LAS VEGAS NV
89084-4723
US

V. Phone/Fax

Practice location:
  • Phone: 702-518-6608
  • Fax:
Mailing address:
  • Phone: 702-518-6608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: IRMA DE SANTIAGO
Title or Position: LMFT
Credential: LMFT
Phone: 702-518-6608