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General NPI Number Information
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NPI Number | 1366363442
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Entity Type | Organization
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Legal Business Name | SERENITY PSYCHOTHERAPY LLC
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Dates
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Enumeration Date | 07/23/2026
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 8 ROAD 3776
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City | FARMINGTON
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State | NM
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Zip | 87401-9504
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Country | US
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Telephone | 505-444-0874
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Fax |
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Provider Business Mailing Address
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Address Line | 8 ROAD 3776
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City | FARMINGTON
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State | NM
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Zip | 87401-9504
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Country | US
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Telephone | 505-444-0874
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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 | ELYSIA RUSSELL
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Credential |
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Telephone | 505-444-0874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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