Provider Demographics
NPI:1003574161
Name:ENLIGHTENED SERENITY COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:ENLIGHTENED SERENITY COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-352-7398
Mailing Address - Street 1:2075 W STADIUM BLVD # 3459
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-7011
Mailing Address - Country:US
Mailing Address - Phone:734-352-7398
Mailing Address - Fax:
Practice Address - Street 1:2075 W STADIUM BLVD # 3459
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-7011
Practice Address - Country:US
Practice Address - Phone:734-352-7398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health