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General NPI Number Information
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NPI Number | 1992696082
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Entity Type | Organization
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Legal Business Name | SHIFAA SERENITY THERAPY SOLUTIONS
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 1251 NILLES RD
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City | FAIRFIELD
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State | OH
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Zip | 45014-7206
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Country | US
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Telephone | 513-446-5048
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 14634
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City | CINCINNATI
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State | OH
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Zip | 45250-0634
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Country | US
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Telephone | 513-446-5048
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Fax |
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Authorized Official
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Title or Position | OWNER/ CEO
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Name | FELISHA T JACKSON ILYAS
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Credential |
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Telephone | 513-446-5048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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