Healthcare Provider Details

I. General information

NPI: 1801724356
Provider Name (Legal Business Name): SERENITY COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 BROOKFIELD RD UNIT A
FORT SALONGA NY
11768-1407
US

IV. Provider business mailing address

34 BROOKFIELD RD UNIT A
FORT SALONGA NY
11768-1407
US

V. Phone/Fax

Practice location:
  • Phone: 516-376-6410
  • Fax:
Mailing address:
  • Phone: 516-376-6410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. KATHRYN MCGOVERN
Title or Position: OWNER
Credential: DAC, LAC, LMT
Phone: 516-376-6410