Provider Demographics
NPI:1508319971
Name:SERENITY COUNSELING SOLUTIONS, LLC
Entity Type:Organization
Organization Name:SERENITY COUNSELING SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WIENER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:440-479-5145
Mailing Address - Street 1:7547 MENTOR AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-5438
Mailing Address - Country:US
Mailing Address - Phone:440-479-5145
Mailing Address - Fax:
Practice Address - Street 1:7547 MENTOR AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5438
Practice Address - Country:US
Practice Address - Phone:440-479-5145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1300702101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty