Provider Demographics
NPI:1346940160
Name:SERENITY RANCH WELLNESS, PLLC
Entity Type:Organization
Organization Name:SERENITY RANCH WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LPC
Authorized Official - Phone:936-333-2653
Mailing Address - Street 1:1814 RED OAK DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-4812
Mailing Address - Country:US
Mailing Address - Phone:951-805-1362
Mailing Address - Fax:
Practice Address - Street 1:902 N SAN JACINTO ST
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-2522
Practice Address - Country:US
Practice Address - Phone:936-333-2653
Practice Address - Fax:936-494-3104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty