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General NPI Number Information
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NPI Number | 1194541623
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Entity Type | Organization
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Legal Business Name | SERENITY HEALTH OF NJ LLC
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Dates
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Enumeration Date | 11/30/2024
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 110 MARTER AVE STE 301
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City | MOORESTOWN
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State | NJ
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Zip | 08057-3124
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Country | US
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Telephone | 856-208-6217
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Fax |
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Provider Business Mailing Address
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Address Line | 110 MARTER AVE STE 301
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City | MOORESTOWN
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State | NJ
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Zip | 08057-3124
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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 | LAURA JEANNE BEARD
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Credential | APN
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Telephone | 856-298-7554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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