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General NPI Number Information
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NPI Number | 1275850349
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Entity Type | Organization
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Legal Business Name | SERENITY PLACE COUNSELING LLC
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Dates
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Enumeration Date | 04/28/2010
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Last Update Date | 04/28/2010
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Provider Practice Location Address
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Address Line | 806 OLD CLEBURNE RD
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City | GRANBURY
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State | TX
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Zip | 76048-1422
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Country | US
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Telephone | 817-579-9559
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Fax | 800-392-2104
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Provider Business Mailing Address
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Address Line | 806 OLD CLEBURNE RD
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City | GRANBURY
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State | TX
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Zip | 76048-1422
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Country | US
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Telephone | 817-579-9559
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Fax | 800-392-2104
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MS. PAULA SCHIRMAN
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Credential | LPC
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Telephone | 817-219-1726
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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 | 15770
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License Number State | TX
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