=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396655890
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SERENITY SERVICES L.C.S.W PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2026
-----------------------------------------------------
Last Update Date | 09/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1075 BROADWAY
-----------------------------------------------------
City | PLEASANTVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10570-2346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-426-7843
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 50 MEMORIAL PLZ UNIT 212
-----------------------------------------------------
City | PLEASANTVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10570-7518
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-769-6029
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MARGARITA CARSON
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 347-769-6029
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------