Provider Demographics
NPI:1023528437
Name:SERENITY COUNSELING, LLC
Entity type:Organization
Organization Name:SERENITY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEE-DEGNER
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LPCC
Authorized Official - Phone:229-343-1822
Mailing Address - Street 1:663 N DIXIE BLVD STE K
Mailing Address - Street 2:
Mailing Address - City:RADCLIFF
Mailing Address - State:KY
Mailing Address - Zip Code:40160-1376
Mailing Address - Country:US
Mailing Address - Phone:229-343-1822
Mailing Address - Fax:502-430-2416
Practice Address - Street 1:663 N DIXIE BLVD STE K
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-1376
Practice Address - Country:US
Practice Address - Phone:229-343-1822
Practice Address - Fax:502-430-2416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY169075101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty