Provider Demographics
NPI:1679341028
Name:SERENITY SOLUTIONS COUNSELING LLC
Entity Type:Organization
Organization Name:SERENITY SOLUTIONS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BALESTRACCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-271-1463
Mailing Address - Street 1:78 TOM WHEELER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH STONINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06359-1132
Mailing Address - Country:US
Mailing Address - Phone:860-271-1463
Mailing Address - Fax:
Practice Address - Street 1:14 MASONS ISLAND RD UNIT 4D
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-2958
Practice Address - Country:US
Practice Address - Phone:860-271-1463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty