Provider Demographics
NPI:1366013484
Name:LIFE OF SERENITY PROFESSIONAL COUNSELING SERVICES PLLC
Entity Type:Organization
Organization Name:LIFE OF SERENITY PROFESSIONAL COUNSELING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SASHA
Authorized Official - Middle Name:SHARMAINE
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:336-419-6210
Mailing Address - Street 1:35 BLUE PINE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NC
Mailing Address - Zip Code:28390-9176
Mailing Address - Country:US
Mailing Address - Phone:336-419-6210
Mailing Address - Fax:
Practice Address - Street 1:35 BLUE PINE DR
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NC
Practice Address - Zip Code:28390-9176
Practice Address - Country:US
Practice Address - Phone:336-419-6210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty