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General NPI Number Information
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NPI Number | 1629748785
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Entity Type | Organization
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Legal Business Name | SERENE LIFE COUNSELING & WELLNESS, PLLC
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Dates
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Enumeration Date | 09/20/2021
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Last Update Date | 11/06/2021
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Provider Practice Location Address
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Address Line | 3061 BERKS WAY STE 201
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City | RALEIGH
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State | NC
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Zip | 27614-6779
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Country | US
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Telephone | 919-335-5601
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Fax |
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Provider Business Mailing Address
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Address Line | 2501 ENGLISH ROSE LN APT 106
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City | RALEIGH
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State | NC
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Zip | 27614-6893
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Country | US
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Telephone | 919-579-1449
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | SHALANDRA HOLLINS
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Credential | MS, LMFT
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Telephone | 919-335-5601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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