Healthcare Provider Details

I. General information

NPI: 1528997277
Provider Name (Legal Business Name): SERENITYBRIDGE COUNSELING AND TRAINING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 W GIBSON ST STE 100
JASPER TX
75951-4970
US

IV. Provider business mailing address

PO BOX 388
JASPER TX
75951-0005
US

V. Phone/Fax

Practice location:
  • Phone: 877-814-1782
  • Fax: 877-671-0786
Mailing address:
  • Phone: 877-814-1782
  • Fax: 877-671-0786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LAKITRIA LIMBRICK
Title or Position: OWNER
Credential: LPC
Phone: 337-317-2187