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General NPI Number Information
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NPI Number | 1427707660
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Entity Type | Organization
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Legal Business Name | LA SERENIDAD PLLC
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Dates
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Enumeration Date | 03/23/2022
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 178 TRIBUTARY CIR
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City | WILMINGTON
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State | NC
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Zip | 28401-7012
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Country | US
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Telephone | 954-544-7766
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Fax |
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Provider Business Mailing Address
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Address Line | 178 TRIBUTARY CIR
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City | WILMINGTON
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State | NC
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Zip | 28401-7012
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Country | US
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Telephone | 954-544-7766
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALAN ROBERT BRAILSFORD DE LOPEZ
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Credential | MSW LCSW
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Telephone | 910-227-9797
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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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