Provider Demographics
NPI:1477252161
Name:SERENITY COUNSELING LICENSED CLINICAL SOCIAL WORKER INC
Entity Type:Organization
Organization Name:SERENITY COUNSELING LICENSED CLINICAL SOCIAL WORKER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARIN
Authorized Official - Middle Name:PAPKEN
Authorized Official - Last Name:JIVALAGIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-507-8525
Mailing Address - Street 1:230 N MARYLAND AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4281
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 N MARYLAND AVE STE 306
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4281
Practice Address - Country:US
Practice Address - Phone:818-507-8525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-01
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty