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NPI 1477252161

NPI 1477252161 : SERENITY COUNSELING LICENSED CLINICAL SOCIAL WORKER INC : GLENDALE, CA

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General NPI Number Information
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    NPI Number           |    1477252161
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    Entity Type          |    Organization 
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    Legal Business Name  |    SERENITY COUNSELING LICENSED CLINICAL SOCIAL WORKER INC 
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Dates
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    Enumeration Date     |    03/01/2023
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    Last Update Date     |    06/05/2023
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Provider Practice Location Address
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    Address Line         |    230 N MARYLAND AVE STE 306 
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    City                 |    GLENDALE
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    State                |    CA
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    Zip                  |    91206-4281
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    Country              |    US
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    Telephone            |    818-507-8525
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    230 N MARYLAND AVE STE 306 
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    City                 |    GLENDALE
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    State                |    CA
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    Zip                  |    91206-4281
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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    |    OWNER
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    Name                 |     SARIN PAPKEN JIVALAGIAN 
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    Credential           |    
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    Telephone            |    818-507-8525
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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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