Provider Demographics
NPI:1780015248
Name:SERENITY COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:SERENITY COUNSELING SERVICES LLC
Other - Org Name:TINA LARRIGAN, LCSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LARRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:314-304-7251
Mailing Address - Street 1:212 BROUGHAM DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-8002
Mailing Address - Country:US
Mailing Address - Phone:314-304-7251
Mailing Address - Fax:636-498-0050
Practice Address - Street 1:1286 JUNGERMANN RD
Practice Address - Street 2:SUITE G
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-6967
Practice Address - Country:US
Practice Address - Phone:636-498-0700
Practice Address - Fax:636-498-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty