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General NPI Number Information
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NPI Number | 1386598969
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Entity Type | Organization
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Legal Business Name | SERENITY MINDS HEALTH
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Dates
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Enumeration Date | 02/23/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 4841 100TH ST NE UNIT A
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City | MARYSVILLE
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State | WA
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Zip | 98270-2352
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Country | US
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Telephone | 214-281-9302
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Fax |
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Provider Business Mailing Address
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Address Line | 82 WENDELL AVE STE 100
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City | PITTSFIELD
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State | MA
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Zip | 01201-7066
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Country | US
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Telephone | 214-281-9302
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | ADEBOLA KAFAYAT ADEGBENRO
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Credential | PMHNP-BC
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Telephone | 214-281-9302
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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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