Provider Demographics
NPI:1225674922
Name:BEERS, SERENNA LYNN (MS, CADC III, MAC)
Entity Type:Individual
Prefix:MS
First Name:SERENNA
Middle Name:LYNN
Last Name:BEERS
Suffix:
Gender:F
Credentials:MS, CADC III, MAC
Other - Prefix:MS
Other - First Name:SERENNA
Other - Middle Name:LYNN
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CADC III, MAC
Mailing Address - Street 1:1325 N HOLLADAY DR
Mailing Address - Street 2:
Mailing Address - City:SEASIDE
Mailing Address - State:OR
Mailing Address - Zip Code:97138-7131
Mailing Address - Country:US
Mailing Address - Phone:503-738-7700
Mailing Address - Fax:503-738-7733
Practice Address - Street 1:9026 BIPLANE WAY
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-4060
Practice Address - Country:US
Practice Address - Phone:916-860-9900
Practice Address - Fax:916-817-1060
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17-10-19101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)