Healthcare Provider Details

I. General information

NPI: 1174477483
Provider Name (Legal Business Name): SERENITY IN SOBRIETY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2026
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 N LOCUST ST
OAK HARBOR OH
43449-1359
US

IV. Provider business mailing address

129 N LOCUST ST
OAK HARBOR OH
43449-1359
US

V. Phone/Fax

Practice location:
  • Phone: 419-607-9188
  • Fax:
Mailing address:
  • Phone: 419-607-9188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JESSICA KITCHIN
Title or Position: OWNER
Credential: LICDC-CS, LPCC
Phone: 419-707-9498