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General NPI Number Information
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NPI Number | 1538493770
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Entity Type | Organization
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Legal Business Name | SERENDIPITY THERAPY, PLLC
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Dates
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Enumeration Date | 09/21/2009
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Last Update Date | 09/15/2016
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Provider Practice Location Address
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Address Line | 1165 MCKEE FARM LANE
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City | BELMONT
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State | NC
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Zip | 28012-8671
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Country | US
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Telephone | 704-928-8266
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 581
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City | CORNELIUS
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State | NC
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Zip | 28031-0581
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Country | US
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Telephone | 704-928-8266
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Fax |
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | KATHERINE FARRELL
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Credential | L.C.S.W
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Telephone | 704-928-8266
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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 | C006381
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License Number State | NC
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