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General NPI Number Information
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NPI Number | 1831799246
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Entity Type | Organization
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Legal Business Name | SERENITY SPRINGS CLINICAL COUNSELING LLC
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 430 SALT MEADOW CIR UNIT 303
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City | BRADENTON
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State | FL
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Zip | 34208-1772
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Country | US
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Telephone | 614-537-7426
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Fax | 844-813-5222
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Provider Business Mailing Address
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Address Line | 5913 PINEVILLE DR
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City | GROVE CITY
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State | OH
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Zip | 43123-2568
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Country | US
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Telephone | 614-537-7426
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CLINICAL COUNSELOR
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Name | MR. TODD WARREN
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Credential | LPCC
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Telephone | 614-537-7426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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