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General NPI Number Information
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NPI Number | 1730970534
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Entity Type | Organization
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Legal Business Name | SERENITY PSYCHIATRY & WELLNESS PLLC
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/18/2025
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Provider Practice Location Address
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Address Line | 502 W 7TH ST STE 100
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City | ERIE
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State | PA
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Zip | 16502-1333
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Country | US
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Telephone | 484-278-1175
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Fax |
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Provider Business Mailing Address
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Address Line | 502 W 7TH ST STE 100
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City | ERIE
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State | PA
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Zip | 16502-1333
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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 | MEMBER/CO-OWNER
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Name | DR. SIDRA GHAFOOR
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Credential | MD
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Telephone | 215-217-2288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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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 | 2084S0010X
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Taxonomy Name | Sports Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #4
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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 #5
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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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Taxonomy #6
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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