Provider Demographics
NPI:1851960538
Name:SERENITY COUNSELING, LLC
Entity Type:Organization
Organization Name:SERENITY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GALL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:907-433-9628
Mailing Address - Street 1:3761 WINTERSET DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5039
Mailing Address - Country:US
Mailing Address - Phone:907-433-9628
Mailing Address - Fax:
Practice Address - Street 1:4050 LAKE OTIS PKWY STE 105
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5220
Practice Address - Country:US
Practice Address - Phone:907-433-9628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)