Provider Demographics
NPI:1467088229
Name:SERENITY MENTAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:SERENITY MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HARRIS-KUIPER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCADC, ACS
Authorized Official - Phone:732-781-5752
Mailing Address - Street 1:28 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILLTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08850-1549
Mailing Address - Country:US
Mailing Address - Phone:732-220-1300
Mailing Address - Fax:732-514-1600
Practice Address - Street 1:28 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MILLTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08850-1549
Practice Address - Country:US
Practice Address - Phone:732-220-1300
Practice Address - Fax:732-514-1600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty