MEDICARE: SERENE COUNSELING AND CONSULTING SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	66711	TX

General Provider Information

NPI Number	:	1316312663
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENE COUNSELING AND CONSULTING SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 3191
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77588-3191
Country	:	US
Telephone Number	:	678-613-7110
Fax Number	:

Provider Business Practice Location Address
First Line	:	6509 MORROW ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-2316
Country	:	US
Telephone Number	:	678-613-7110
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ROXANNE DEAMS
Credential	:	LPC
Telephone Number	:	678-613-7110

Provider Enumeration Date	:	12/10/2015
Last Update Date	:	12/10/2015

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Directions to “SERENE COUNSELING AND CONSULTING SERVICES ” Practice Location

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