MEDICARE: SERENITY TREATMENT CENTER, INC.

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1992027726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY TREATMENT CENTER, INC.

Provider Business Mailing Address
First Line	:	5703 INDUSTRY LN UNIT 103-104
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21704-7263
Country	:	US
Telephone Number	:	301-898-2627
Fax Number	:	301-898-2640

Provider Business Practice Location Address
First Line	:	5703 INDUSTRY LANE
Second Line	:	UNIT 103-104
City	:	FREDERICK
State	:	MD
Zip	:	21704-7263
Country	:	US
Telephone Number	:	301-898-2627
Fax Number	:	301-898-2640

Authorized Official
Title or Position	:	CEO
Name	:	SEAN NICHOLSON
Credential	:
Telephone Number	:	240-457-8874

Provider Enumeration Date	:	02/21/2010
Last Update Date	:	03/06/2026

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