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General NPI Number Information
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NPI Number | 1003390238
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Entity Type | Organization
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Legal Business Name | SERENITY POINT COUNSELING AND WELLNESS PLLC
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Dates
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Enumeration Date | 09/24/2018
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Last Update Date | 09/24/2018
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Provider Practice Location Address
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Address Line | 901 S WASHINGTON AVE
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City | LUDINGTON
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State | MI
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Zip | 49431-2571
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Country | US
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Telephone | 231-425-3180
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Fax | 231-425-4951
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Provider Business Mailing Address
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Address Line | 901 S WASHINGTON AVE
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City | LUDINGTON
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State | MI
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Zip | 49431-2571
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Country | US
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Telephone | 231-425-3180
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Fax | 231-425-4951
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Authorized Official
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Title or Position | OWNER
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Name | REBECCA SUE LANGE
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Credential | LMSW
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Telephone | 231-425-3180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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