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General NPI Number Information
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NPI Number | 1851095509
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Entity Type | Organization
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Legal Business Name | SERENITY WELLNESS GROUP, INC.
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Dates
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Enumeration Date | 03/28/2023
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 2306 BOULVARD
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2316
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Country | US
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Telephone | 804-243-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 205 TEMPLE AVE
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2827
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Country | US
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Telephone | 804-243-5800
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | QAADIRA WARITH-MUHAMMAD
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Credential | RESIDENT
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Telephone | 804-243-6800
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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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Taxonomy #2
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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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