Provider Demographics
NPI:1851938377
Name:SERENITY PRESENTATIONS LLC
Entity Type:Organization
Organization Name:SERENITY PRESENTATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:203-788-2821
Mailing Address - Street 1:11 SERENITY LN
Mailing Address - Street 2:
Mailing Address - City:SANDY HOOK
Mailing Address - State:CT
Mailing Address - Zip Code:06482-1630
Mailing Address - Country:US
Mailing Address - Phone:203-788-2821
Mailing Address - Fax:
Practice Address - Street 1:11 SERENITY LN
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:CT
Practice Address - Zip Code:06482-1630
Practice Address - Country:US
Practice Address - Phone:203-788-2821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000955OtherCT DEPARTMENT OF HEALTH