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General NPI Number Information
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NPI Number | 1023528437
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Entity Type | Organization
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Legal Business Name | SERENITY COUNSELING, LLC
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Dates
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Enumeration Date | 10/11/2017
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Last Update Date | 03/11/2020
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Provider Practice Location Address
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Address Line | 663 N DIXIE BLVD STE K
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City | RADCLIFF
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State | KY
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Zip | 40160-1376
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Country | US
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Telephone | 229-343-1822
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Fax | 502-430-2416
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Provider Business Mailing Address
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Address Line | 663 N DIXIE BLVD STE K
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City | RADCLIFF
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State | KY
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Zip | 40160-1376
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Country | US
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Telephone | 229-343-1822
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Fax | 502-430-2416
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | AMANDA J LEE-DEGNER
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Credential | ED.D., LPCC
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Telephone | 229-343-1822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 169075
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License Number State | KY
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