Provider Demographics
NPI:1235605320
Name:SERENITY HOPE CONSULTING SERVICES INC
Entity Type:Organization
Organization Name:SERENITY HOPE CONSULTING SERVICES INC
Other - Org Name:SERENITY HOPE CONSULTING SERVICES INC COUNSELING AND THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:STONEHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-946-0143
Mailing Address - Street 1:15230 SE 105TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-4618
Mailing Address - Country:US
Mailing Address - Phone:919-946-0143
Mailing Address - Fax:
Practice Address - Street 1:13940 N US HIGHWAY 441 STE 210
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-8909
Practice Address - Country:US
Practice Address - Phone:919-946-0143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health