Provider Demographics
NPI:1881218436
Name:SERENE COUNSELING, LLC
Entity Type:Organization
Organization Name:SERENE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHILDS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CSAC, CS-IT
Authorized Official - Phone:715-661-4474
Mailing Address - Street 1:148 S AVON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILLIPS
Mailing Address - State:WI
Mailing Address - Zip Code:54555-1308
Mailing Address - Country:US
Mailing Address - Phone:715-661-4474
Mailing Address - Fax:
Practice Address - Street 1:148 S AVON AVE
Practice Address - Street 2:
Practice Address - City:PHILLIPS
Practice Address - State:WI
Practice Address - Zip Code:54555-1308
Practice Address - Country:US
Practice Address - Phone:715-661-4474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health