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General NPI Number Information
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NPI Number | 1265925648
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Entity Type | Organization
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Legal Business Name | SERENITY PROMISE
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 2430 SOUTHLAND DR STE 7
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City | CHESTER
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State | VA
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Zip | 23831-2354
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Country | US
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Telephone | 804-439-2206
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Fax | 804-743-2591
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Provider Business Mailing Address
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Address Line | 4540 COCHISE TRL
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23237-2559
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Country | US
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Telephone | 804-439-2206
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Fax | 858-365-5616
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. SONYA BONITA WEAVER
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Credential | PMHNP
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Telephone | 804-439-2206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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