MEDICARE: SERENITYBRIDGE COUNSELING AND TRAINING CENTER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
3	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1528997277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITYBRIDGE COUNSELING AND TRAINING CENTER

Provider Business Mailing Address
First Line	:	PO BOX 388
Second Line	:
City	:	JASPER
State	:	TX
Zip	:	75951-0005
Country	:	US
Telephone Number	:	877-814-1782
Fax Number	:	877-671-0786

Provider Business Practice Location Address
First Line	:	103 W GIBSON ST STE 100
Second Line	:
City	:	JASPER
State	:	TX
Zip	:	75951-4970
Country	:	US
Telephone Number	:	877-814-1782
Fax Number	:	877-671-0786

Authorized Official
Title or Position	:	OWNER
Name	:	LAKITRIA LIMBRICK
Credential	:	LPC
Telephone Number	:	337-317-2187

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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