Provider Demographics
NPI:1699217737
Name:SEA OF SERENITY THERAPY LLC
Entity Type:Organization
Organization Name:SEA OF SERENITY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PROFESSIONAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:LEMICH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:540-361-4330
Mailing Address - Street 1:305 HANSON AVE STE 170
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3175
Mailing Address - Country:US
Mailing Address - Phone:540-361-4330
Mailing Address - Fax:540-361-4331
Practice Address - Street 1:305 HANSON AVE STE 170
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3175
Practice Address - Country:US
Practice Address - Phone:540-361-4330
Practice Address - Fax:540-361-4331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006299101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty