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General NPI Number Information
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NPI Number | 1366290652
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Entity Type | Organization
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Legal Business Name | SERENITY & WELLNESS PATHWAYS, PLLC
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Dates
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Enumeration Date | 05/10/2024
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 6212 LES DORSON LN
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City | ALEXANDRIA
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State | VA
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Zip | 22315-3228
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Country | US
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Telephone | 202-235-4909
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Fax |
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Provider Business Mailing Address
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Address Line | 6212 LES DORSON LN
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City | ALEXANDRIA
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State | VA
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Zip | 22315-3228
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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 | CLINICAL PSYCHOLOGIST
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Name | DR. BRIANNA ECTOR
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Credential | PSY.D
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Telephone | 202-235-4909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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