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General NPI Number Information
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NPI Number | 1356636831
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Entity Type | Organization
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Legal Business Name | SERENITY COUNSELING FOR ALL AGES, INC.
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Dates
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Enumeration Date | 06/13/2011
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Last Update Date | 06/13/2011
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Provider Practice Location Address
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Address Line | 5084 BRASHER AVE
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City | BLUE ASH
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State | OH
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Zip | 45242-3906
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Country | US
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Telephone | 513-793-3661
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Fax |
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Provider Business Mailing Address
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Address Line | 5084 BRASHER AVE
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City | BLUE ASH
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State | OH
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Zip | 45242-3906
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Country | US
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Telephone | 513-793-3661
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MELONIE GROSSER
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Credential | PCC/S
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Telephone | 513-793-3661
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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 | E4180
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License Number State | OH
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