MEDICARE: SERENITY MENTAL HEALTH AND WELLNESS LLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1780535757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY MENTAL HEALTH AND WELLNESS LLC

Provider Business Mailing Address
First Line	:	2212 S CHICKASAW TRL STE 1069
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-8414
Country	:	US
Telephone Number	:	407-986-1046
Fax Number	:	689-348-7003

Provider Business Practice Location Address
First Line	:	15615 HONEYBELL DR
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-5065
Country	:	US
Telephone Number	:	407-986-1046
Fax Number	:	689-348-7003

Authorized Official
Title or Position	:	LICENSED MENTAL HEALTH COUNSELOR
Name	:	MRS. KALIMA THEMA JACKSON-WILLS
Credential	:	LMHC
Telephone Number	:	407-986-1046

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

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