Provider Demographics
NPI:1043785124
Name:SERENITY MENTAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:SERENITY MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, NP-C, PMHNP-BC
Authorized Official - Phone:225-255-0899
Mailing Address - Street 1:PO BOX 1726
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-1726
Mailing Address - Country:US
Mailing Address - Phone:225-255-0899
Mailing Address - Fax:225-341-4345
Practice Address - Street 1:2900 WESTFORK DR STE 401
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70827-0004
Practice Address - Country:US
Practice Address - Phone:225-255-0899
Practice Address - Fax:225-341-4345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-04
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2308360Medicaid