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General NPI Number Information
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NPI Number | 1760263602
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Entity Type | Organization
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Legal Business Name | EMPOWERED SERENITY COUNSELING LLC
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Dates
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Enumeration Date | 10/06/2023
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 4121 UNION RD STE 225
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City | SAINT LOUIS
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State | MO
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Zip | 63129-1093
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Country | US
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Telephone | 314-730-6787
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Fax |
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Provider Business Mailing Address
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Address Line | 9963 HERITAGE DR APT C
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City | SAINT LOUIS
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State | MO
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Zip | 63123-4169
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Country | US
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Telephone | 314-753-5728
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | NICOLE SECKEL
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Credential | LPC
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Telephone | 314-753-5728
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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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