NPI Code Details Logo

NPI 1568267896

NPI 1568267896 : SERENITY MINDFUL HEALING, PLLC : GEORGETOWN, TX

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1568267896
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    SERENITY MINDFUL HEALING, PLLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/19/2025
-----------------------------------------------------
    Last Update Date     |    07/15/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1616 WILLIAMS DR STE 102 
-----------------------------------------------------
    City                 |    GEORGETOWN
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    78628-3660
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    512-630-8166
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    4123 GRANADA DR 
-----------------------------------------------------
    City                 |    GEORGETOWN
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    78628-1617
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    512-630-8166
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     SARAH ANN WHITE 
-----------------------------------------------------
    Credential           |    LPC
-----------------------------------------------------
    Telephone            |    512-630-8166
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    101YP2500X
-----------------------------------------------------
    Taxonomy Name        |    Professional Counselor
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.