Provider Demographics
NPI:1083304810
Name:SERENITY PSYCHIATRIC & COUNSELING SERVICES
Entity Type:Organization
Organization Name:SERENITY PSYCHIATRIC & COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:BOUSI
Authorized Official - Last Name:NJUGUNA
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:302-981-6124
Mailing Address - Street 1:1199 AMBOY AVE STE 287-F5
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2552
Mailing Address - Country:US
Mailing Address - Phone:732-333-7249
Mailing Address - Fax:
Practice Address - Street 1:1199 AMBOY AVE STE 287-F5
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2552
Practice Address - Country:US
Practice Address - Phone:732-333-7249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty