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General NPI Number Information
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NPI Number | 1083236665
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Entity Type | Organization
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Legal Business Name | SERENITY THERAPY SERVICES LLC
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Dates
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Enumeration Date | 05/18/2020
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Last Update Date | 05/18/2020
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Provider Practice Location Address
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Address Line | 2300 MONTANA AVE STE 536
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City | CINCINNATI
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State | OH
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Zip | 45211-3829
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Country | US
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Telephone | 513-202-4095
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 QUEEN CITY AVE APT 6
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City | CINCINNATI
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State | OH
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Zip | 45238-2490
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, LEAD THERAPIST
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Name | MRS. TAHLISHA S DORSEY
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Credential | LISW
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Telephone | 513-387-9870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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