MEDICARE: SERENITY NOW HOLISTIC MENTAL HEALTH

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1336099050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY NOW HOLISTIC MENTAL HEALTH

Provider Business Mailing Address
First Line	:	122 PINE GROVE CIR
Second Line	:
City	:	CLOVER
State	:	SC
Zip	:	29710-8943
Country	:	US
Telephone Number	:	803-373-9378
Fax Number	:	803-373-9378

Provider Business Practice Location Address
First Line	:	122 PINE GROVE CIR
Second Line	:
City	:	CLOVER
State	:	SC
Zip	:	29710-8943
Country	:	US
Telephone Number	:	980-875-8512
Fax Number	:	980-875-8512

Authorized Official
Title or Position	:	OWNER/MANAGING MEMBER
Name	:	LAURA GLASS
Credential	:	NP
Telephone Number	:	803-373-9378

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	05/20/2026

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