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General NPI Number Information
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NPI Number | 1780196170
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Entity Type | Organization
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Legal Business Name | SERENITY COUNSELING & WELLNESS
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Dates
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Enumeration Date | 10/25/2017
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Last Update Date | 03/09/2020
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Provider Practice Location Address
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Address Line | 90 3RD AVE # 2
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City | HAWTHORNE
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State | NJ
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Zip | 07506-2414
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Country | US
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Telephone | 973-348-5594
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1586
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City | PATERSON
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State | NJ
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Zip | 07509-1586
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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 | LEAD CLINICIAN
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Name | MISS DHESYRE NOVOA
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Credential | LCSW
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Telephone | 973-348-5594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SL06197900
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License Number State | NJ
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