Provider Demographics
NPI:1376136168
Name:SOLE SERENITY THERAPY PLLC
Entity Type:Organization
Organization Name:SOLE SERENITY THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LARAMORE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-740-9455
Mailing Address - Street 1:1101 S. MAIN ST. STE 100 #328
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118
Mailing Address - Country:US
Mailing Address - Phone:734-740-9455
Mailing Address - Fax:
Practice Address - Street 1:4211 INVERNESS ST
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MI
Practice Address - Zip Code:48130-1460
Practice Address - Country:US
Practice Address - Phone:734-740-9455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty