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General NPI Number Information
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NPI Number | 1871318196
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Entity Type | Organization
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Legal Business Name | SERENITY MINDS LLC
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 54 S MARION ST
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City | BLOOMVILLE
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State | OH
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Zip | 44818-9201
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Country | US
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Telephone | 567-207-5377
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Fax | 888-518-4977
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Provider Business Mailing Address
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Address Line | 54 S MARION ST
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City | BLOOMVILLE
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State | OH
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Zip | 44818-9201
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Country | US
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Telephone | 567-207-5377
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Fax | 888-518-4977
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Authorized Official
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Title or Position | OWNER, LPCC, LICDC
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Name | MRS. JESSICA ROHRBACH
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Credential | LPCC, LICDC
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Telephone | 567-207-5377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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 | 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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