=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760326268
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PERSONALIZED SERENITY COUNSELING SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/15/2026
-----------------------------------------------------
Last Update Date | 04/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 60 MAIN ST UNIT 153
-----------------------------------------------------
City | WOODBRIDGE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07095-6612
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-694-9685
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 153
-----------------------------------------------------
City | WOODBRIDGE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07095-0153
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-694-9685
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MS. KERRY-ANN MELECIA RICHARDS
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 347-694-9685
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------