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General NPI Number Information
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NPI Number | 1962980193
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Entity Type | Organization
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Legal Business Name | SERENITY COUNSELING AND SERVICES. LLC
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Dates
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Enumeration Date | 07/31/2018
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 91 SHELTON AVE
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City | NEW HAVEN
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State | CT
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Zip | 06511
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Country | US
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Telephone | 475-238-8355
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Fax | 475-238-8355
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Provider Business Mailing Address
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Address Line | 18 DONNA LN
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City | WEST HAVEN
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State | CT
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Zip | 06516-5521
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Country | US
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Telephone | 203-676-2402
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MS. DAMARIS RODRIGUEZ
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Credential | LCSW
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Telephone | 203-676-2402
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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 | 009488
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License Number State | CT
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