Healthcare Provider Details

I. General information

NPI: 1154790467
Provider Name (Legal Business Name): SERENITY BEHAVIORAL HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2015
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6699 CHIMNEY ROCK RD SUITE 201
HOUSTON TX
77081-5358
US

IV. Provider business mailing address

6699 CHIMNEY ROCK RD SUITE 201
HOUSTON TX
77081-5358
US

V. Phone/Fax

Practice location:
  • Phone: 832-530-4352
  • Fax: 832-530-4364
Mailing address:
  • Phone: 832-530-4352
  • Fax: 832-530-4364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License NumberN0572
License Number StateTX

VIII. Authorized Official

Name: DR. JENNIFER YEN
Title or Position: MANAGER
Credential:
Phone: 832-530-4352