Provider Demographics
NPI:1164399101
Name:SERENITY SUMMIT PSYCHOLOGY
Entity type:Organization
Organization Name:SERENITY SUMMIT PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER - MENTAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:SONAL
Authorized Official - Middle Name:BHAVESH
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:781-552-1853
Mailing Address - Street 1:20 WEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1180
Mailing Address - Country:US
Mailing Address - Phone:781-552-1853
Mailing Address - Fax:
Practice Address - Street 1:20 WEDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-1180
Practice Address - Country:US
Practice Address - Phone:781-214-1163
Practice Address - Fax:781-839-9806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty