Healthcare Provider Details

I. General information

NPI: 1538920327
Provider Name (Legal Business Name): SERENITY WELLNESS & COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2024
Last Update Date: 01/18/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52E-3 ESTATE THOMAS ST THOMAS
USVI VI
00802
US

IV. Provider business mailing address

PO BOX 302278
ST THOMAS VI
00803-2278
US

V. Phone/Fax

Practice location:
  • Phone: 340-513-0418
  • Fax:
Mailing address:
  • Phone: 340-513-0418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. NOUR SUID
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential:
Phone: 340-513-0418