Provider Demographics
NPI:1922550342
Name:SERENITY FOR YOUTH &FAMILIES
Entity Type:Organization
Organization Name:SERENITY FOR YOUTH &FAMILIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMARE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERSAINT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, CRC, LPC
Authorized Official - Phone:412-523-9981
Mailing Address - Street 1:400 PENN CENTER BLVD
Mailing Address - Street 2:SUITE 312
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-5613
Mailing Address - Country:US
Mailing Address - Phone:412-523-9981
Mailing Address - Fax:
Practice Address - Street 1:400 PENN CENTER BLVD
Practice Address - Street 2:SUITE 312
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-5613
Practice Address - Country:US
Practice Address - Phone:412-523-9981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008312101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103170615Medicaid