Provider Demographics
NPI:1356636831
Name:SERENITY COUNSELING FOR ALL AGES, INC.
Entity Type:Organization
Organization Name:SERENITY COUNSELING FOR ALL AGES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MELONIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSSER
Authorized Official - Suffix:
Authorized Official - Credentials:PCC/S
Authorized Official - Phone:513-793-3661
Mailing Address - Street 1:5084 BRASHER AVE
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-3906
Mailing Address - Country:US
Mailing Address - Phone:513-793-3661
Mailing Address - Fax:
Practice Address - Street 1:5084 BRASHER AVE
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-3906
Practice Address - Country:US
Practice Address - Phone:513-793-3661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE4180101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty