Provider Demographics
NPI:1629561071
Name:SERENITY FIRST COUNSELING, LLC
Entity Type:Organization
Organization Name:SERENITY FIRST COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SILVER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:520-398-7272
Mailing Address - Street 1:136 W VUELTA FRISO
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-8672
Mailing Address - Country:US
Mailing Address - Phone:818-371-7463
Mailing Address - Fax:
Practice Address - Street 1:170 N LA CANADA DR STE 30C
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-3139
Practice Address - Country:US
Practice Address - Phone:520-398-7272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-10221261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)