Provider Demographics
NPI:1669045761
Name:SERENITY MENTAL HEALTH PLLC
Entity Type:Organization
Organization Name:SERENITY MENTAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:ANGELO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP - BC
Authorized Official - Phone:903-347-1560
Mailing Address - Street 1:320 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:75494-2524
Mailing Address - Country:US
Mailing Address - Phone:903-347-1560
Mailing Address - Fax:903-347-6500
Practice Address - Street 1:320 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:TX
Practice Address - Zip Code:75494-2524
Practice Address - Country:US
Practice Address - Phone:033-471-5609
Practice Address - Fax:903-347-6500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty