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NPI 1104590447

NPI 1104590447 : SERENITY 7 COUNSELING SERVICES, PLLC : LAURINBURG, NC

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General NPI Number Information
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    NPI Number           |    1104590447
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    Entity Type          |    Organization 
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    Legal Business Name  |    SERENITY 7 COUNSELING SERVICES, PLLC 
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Dates
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    Enumeration Date     |    08/02/2021
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    Last Update Date     |    08/02/2021
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Provider Practice Location Address
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    Address Line         |    303 ATKINSON ST 
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    City                 |    LAURINBURG
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    State                |    NC
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    Zip                  |    28352-3633
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    Country              |    US
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    Telephone            |    910-318-3012
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    12820 WOODBRIGE DRIVE 
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    City                 |    LAURINBURG
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    State                |    NC
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    Zip                  |    28352
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    Country              |    US
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    Telephone            |    910-318-3012
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    Fax                  |    
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Authorized Official
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    Title or Position    |    LICENSED CLINICAL SOCIAL WORKER
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    Name                 |     TERESA W SAMUEL 
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    Credential           |    LCSW
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    Telephone            |    910-318-3012
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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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