Provider Demographics
NPI:1316597420
Name:JASMINESERENE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:JASMINESERENE COUNSELING SERVICES, LLC
Other - Org Name:SERENE COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED, LP C
Authorized Official - Phone:256-330-4713
Mailing Address - Street 1:2346 PANSY ST. SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3803
Mailing Address - Country:US
Mailing Address - Phone:256-330-4713
Mailing Address - Fax:256-330-4131
Practice Address - Street 1:2346 PANSY ST. SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3803
Practice Address - Country:US
Practice Address - Phone:256-330-4713
Practice Address - Fax:256-330-4131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health