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General NPI Number Information
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NPI Number | 1154955391
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Entity Type | Organization
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Legal Business Name | SERENITY PEAKS, LLC
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Dates
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Enumeration Date | 02/26/2020
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 390 SORREL ST
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-7850
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Country | US
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Telephone | 970-623-1857
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Fax |
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Provider Business Mailing Address
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Address Line | 3024 BIG BIRD AVE
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City | GRAND JUNCTION
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State | CO
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Zip | 81504-4100
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Country | US
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Telephone | 970-623-1857
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Fax |
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Authorized Official
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Title or Position | OWNER/LPC
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Name | HOLLIE DEANN SMITH
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Credential | LPC
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Telephone | 970-623-1857
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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 |
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License Number State |
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