Provider Demographics
NPI:1811405376
Name:SERENITY FAMILY COUNSELING LLC
Entity Type:Organization
Organization Name:SERENITY FAMILY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OUTPATIENT THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCHWARZROCK
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW, RPT
Authorized Official - Phone:507-338-5600
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:NEW ULM
Mailing Address - State:MN
Mailing Address - Zip Code:56073-0012
Mailing Address - Country:US
Mailing Address - Phone:507-338-5600
Mailing Address - Fax:888-338-6234
Practice Address - Street 1:210 20TH SOUTH ST
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073-2223
Practice Address - Country:US
Practice Address - Phone:507-338-5600
Practice Address - Fax:888-338-6234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN227821041C0700X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)