Provider Demographics
NPI:1639763741
Name:SERENDIPITY ASSOCIATES MENTAL HEALTH SERVICES PLLC
Entity Type:Organization
Organization Name:SERENDIPITY ASSOCIATES MENTAL HEALTH SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER /OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENIKA
Authorized Official - Middle Name:LANAY
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:DNP , CRNP
Authorized Official - Phone:215-701-4782
Mailing Address - Street 1:1246 SEQUOIA RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2653
Mailing Address - Country:US
Mailing Address - Phone:215-805-5281
Mailing Address - Fax:
Practice Address - Street 1:14 KINGS CT
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040-4801
Practice Address - Country:US
Practice Address - Phone:215-701-4782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty