Provider Demographics
NPI:1225517451
Name:SERENITY COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:SERENITY COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LISW-S
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MESSERSMITH-MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-776-7369
Mailing Address - Street 1:6333 SKYWAE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2116
Mailing Address - Country:US
Mailing Address - Phone:614-859-5147
Mailing Address - Fax:
Practice Address - Street 1:3962 N HAMPTON DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-8430
Practice Address - Country:US
Practice Address - Phone:614-859-5147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSW127104104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty