MEDICARE: SERENITY ALIGN WELLNESS AND COUNSELING PLLC

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1740873603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY ALIGN WELLNESS AND COUNSELING PLLC

Provider Business Mailing Address
First Line	:	1515 AUSTIN ST APT 1604
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-3362
Country	:	US
Telephone Number	:	773-782-5538
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 AUSTIN ST APT 1604
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-3362
Country	:	US
Telephone Number	:	773-782-5538
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ASHLEY BAKER
Credential	:	LCSW
Telephone Number	:	773-782-5538

Provider Enumeration Date	:	02/11/2021
Last Update Date	:	02/11/2021

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