Provider Demographics
NPI:1972184109
Name:SERENITY COUNSELING
Entity Type:Organization
Organization Name:SERENITY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:EAVES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:812-629-3994
Mailing Address - Street 1:5301 E FERRY RD
Mailing Address - Street 2:
Mailing Address - City:GLADYS
Mailing Address - State:VA
Mailing Address - Zip Code:24554-3253
Mailing Address - Country:US
Mailing Address - Phone:812-629-3994
Mailing Address - Fax:
Practice Address - Street 1:1203 BEAVERTAIL DR
Practice Address - Street 2:
Practice Address - City:BRUCETON MILLS
Practice Address - State:WV
Practice Address - Zip Code:26525-5859
Practice Address - Country:US
Practice Address - Phone:812-629-3994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-19
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health