Healthcare Provider Details

I. General information

NPI: 1346831070
Provider Name (Legal Business Name): SERENITY PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2021
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 OXFORD VALLEY RD STE 603A
YARDLEY PA
19067-7712
US

IV. Provider business mailing address

401 CHERRY HILL BLVD
CHERRY HILL NJ
08002-1911
US

V. Phone/Fax

Practice location:
  • Phone: 646-875-9602
  • Fax:
Mailing address:
  • Phone: 267-538-1333
  • Fax: 267-538-1343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. MICHAEL L RASKIND
Title or Position: OWNER
Credential: LCSW
Phone: 267-538-1333