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General NPI Number Information
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NPI Number | 1821879057
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Entity Type | Organization
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Legal Business Name | SERENITY BEHAVIORAL THERAPIES, PLLC
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 200 VALENCIA DR STE 162
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City | JACKSONVILLE
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State | NC
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Zip | 28546-6314
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Country | US
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Telephone | 910-381-3010
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Fax | 910-378-7931
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Provider Business Mailing Address
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Address Line | 200 VALENCIA DR STE 162
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City | JACKSONVILLE
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State | NC
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Zip | 28546-6314
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Country | US
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Telephone | 910-381-3010
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Fax | 910-378-7931
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MRS. JAMESZETTA THOMPSON HARDISON
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Credential | MA, LPA, LMFT
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Telephone | 910-381-3010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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