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General NPI Number Information
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NPI Number | 1972219426
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Entity Type | Organization
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Legal Business Name | THERAPY WITH SERENITY
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Dates
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Enumeration Date | 01/27/2023
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 180 KELLOGG BLVD E APT 1406
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City | SAINT PAUL
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State | MN
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Zip | 55101-1592
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Country | US
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Telephone | 651-419-6967
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Fax | 651-560-3898
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Provider Business Mailing Address
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Address Line | 1041 GRAND AVE STE 135
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City | SAINT PAUL
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State | MN
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Zip | 55105-3002
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Country | US
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Telephone | 651-419-6967
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SERENITY SILVERS
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Credential | MPS, LPCC, LADC
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Telephone | 651-419-6967
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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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