Provider Demographics
NPI:1235584806
Name:SERENITY'S SOULFUL HEALING WELLNESS COUNSELING & CONSULTATION LLC
Entity Type:Organization
Organization Name:SERENITY'S SOULFUL HEALING WELLNESS COUNSELING & CONSULTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PCC
Authorized Official - Phone:740-472-9022
Mailing Address - Street 1:229 W MARIETTA ST
Mailing Address - Street 2:P.O. BOX 242
Mailing Address - City:WOODSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:43793-1051
Mailing Address - Country:US
Mailing Address - Phone:740-472-9022
Mailing Address - Fax:
Practice Address - Street 1:229 W MARIETTA ST
Practice Address - Street 2:
Practice Address - City:WOODSFIELD
Practice Address - State:OH
Practice Address - Zip Code:43793-1051
Practice Address - Country:US
Practice Address - Phone:740-472-9022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0004359101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty