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General NPI Number Information
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NPI Number | 1548813512
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Entity Type | Organization
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Legal Business Name | SERENITY COUNSELING LLC
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 54320 COUNTY ROAD 388
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City | GRAND JCT
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State | MI
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Zip | 49056-9272
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Country | US
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Telephone | 269-363-2302
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 324
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City | GRAND JUNCTION
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State | MI
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Zip | 49056-0324
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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 | TIFFANNI MIELKE
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Credential |
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Telephone | 269-363-2302
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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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