Provider Demographics
NPI:1851450761
Name:SERENITY COUNSELING CENTER
Entity Type:Organization
Organization Name:SERENITY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FLEMMING
Authorized Official - Suffix:SR
Authorized Official - Credentials:DMIN
Authorized Official - Phone:773-643-0500
Mailing Address - Street 1:2011 E 75TH SUITE 106
Mailing Address - Street 2:PO BOX 19506
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649
Mailing Address - Country:US
Mailing Address - Phone:773-643-0500
Mailing Address - Fax:773-643-0545
Practice Address - Street 1:2011 E 75TH
Practice Address - Street 2:SUITE 103
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649
Practice Address - Country:US
Practice Address - Phone:773-643-0500
Practice Address - Fax:773-643-0545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01618891OtherBCBS