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General NPI Number Information
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NPI Number | 1669750345
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Entity Type | Organization
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Legal Business Name | SERENITY COUNSELING & CONSULTING SERVICES
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Dates
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Enumeration Date | 07/28/2011
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Last Update Date | 08/23/2011
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Provider Practice Location Address
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Address Line | 290 HIGHWAY 314 SUITE D
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7813
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Country | US
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Telephone | 404-966-6752
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Fax |
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Provider Business Mailing Address
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Address Line | PMB 198 1029 PEACHTREE PARKWAY NORTH
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City | PEACHTREE CITY
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State | GA
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Zip | 30269
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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 | CEO
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Name | ANDREA J ADAMS
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Credential | LPC
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Telephone | 404-966-6752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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