Provider Demographics
NPI:1821879057
Name:SERENITY BEHAVIORAL THERAPIES, PLLC
Entity Type:Organization
Organization Name:SERENITY BEHAVIORAL THERAPIES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMESZETTA
Authorized Official - Middle Name:THOMPSON
Authorized Official - Last Name:HARDISON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPA, LMFT
Authorized Official - Phone:910-381-3010
Mailing Address - Street 1:200 VALENCIA DR STE 162
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-6314
Mailing Address - Country:US
Mailing Address - Phone:910-381-3010
Mailing Address - Fax:910-378-7931
Practice Address - Street 1:200 VALENCIA DR STE 162
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6314
Practice Address - Country:US
Practice Address - Phone:910-381-3010
Practice Address - Fax:910-378-7931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health