=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093633950
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TOTAL SERENITY WELLNESS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2026
-----------------------------------------------------
Last Update Date | 07/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3301 N MARKET ST
-----------------------------------------------------
City | WILMINGTON
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19802-2738
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-575-8876
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 55 EMERALD RIDGE DR
-----------------------------------------------------
City | BEAR
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19701-2233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-575-8876
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PMHNP-BC
-----------------------------------------------------
Name | MRS. KRISTINA SHERIE MOTLEY
-----------------------------------------------------
Credential | PMHNP-BC
-----------------------------------------------------
Telephone | 267-575-8876
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------