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General NPI Number Information
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NPI Number | 1225517451
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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 | 08/08/2018
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 3962 N HAMPTON DR
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City | POWELL
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State | OH
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Zip | 43065-8430
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Country | US
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Telephone | 614-859-5147
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Fax |
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Provider Business Mailing Address
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Address Line | 6333 SKYWAE DR
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City | COLUMBUS
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State | OH
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Zip | 43229-2116
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Country | US
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Telephone | 614-859-5147
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Fax |
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Authorized Official
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Title or Position | LISW-S
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Name | JESSICA MESSERSMITH-MILLER
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Credential |
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Telephone | 215-776-7369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW127104
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License Number State | OH
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