Provider Demographics
NPI:1639767189
Name:A SERENE MIND COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:A SERENE MIND COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARLINGTON
Authorized Official - Middle Name:
Authorized Official - Last Name:OCANSEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:848-391-1232
Mailing Address - Street 1:1720 LAKE DOW RD STE T-300
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-3643
Mailing Address - Country:US
Mailing Address - Phone:848-391-1232
Mailing Address - Fax:
Practice Address - Street 1:1720 LAKE DOW RD STE T-300
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-3643
Practice Address - Country:US
Practice Address - Phone:848-391-1232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2023-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty