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General NPI Number Information
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NPI Number | 1609714211
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Entity Type | Organization
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Legal Business Name | SERENITY BRIDGE TELEPSYCHIATRY & WEIGHT MANAGEMENT, LLC
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Dates
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Enumeration Date | 03/24/2026
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Last Update Date | 03/24/2026
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Provider Practice Location Address
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Address Line | 60 MEADOW OVERLOOK DR
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City | COVINGTON
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State | GA
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Zip | 30016
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Country | US
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Telephone | 470-236-1785
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Fax |
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Provider Business Mailing Address
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Address Line | 2274 SALEM RD SUITE 106, #1259
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City | CONYERS
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State | GA
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Zip | 30013-2295
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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 | NURSE PRACTITIONER
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Name | STELLA THOMAS
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Credential | NP
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Telephone | 470-236-1785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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