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General NPI Number Information
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NPI Number | 1114817657
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Entity Type | Organization
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Legal Business Name | SERENITY COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 20500 SE HIGHWAY 212
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City | DAMASCUS
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State | OR
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Zip | 97089-7254
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Country | US
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Telephone | 503-880-0136
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Fax |
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Provider Business Mailing Address
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Address Line | 20500 SE HIGHWAY 212
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City | DAMASCUS
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State | OR
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Zip | 97089-7254
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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
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Name | SHALAINE MISTRETTA
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Credential | LCSW
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Telephone | 503-880-0136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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