Provider Demographics
NPI:1205489036
Name:SERENITY COUNSEILNG SERVICES
Entity type:Organization
Organization Name:SERENITY COUNSEILNG SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:815-823-2876
Mailing Address - Street 1:25260 W BUELL ST
Mailing Address - Street 2:
Mailing Address - City:CHANNAHON
Mailing Address - State:IL
Mailing Address - Zip Code:60410-5535
Mailing Address - Country:US
Mailing Address - Phone:815-823-2876
Mailing Address - Fax:
Practice Address - Street 1:1002 N 129TH INFANTRY DR STE F
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-3109
Practice Address - Country:US
Practice Address - Phone:815-823-2876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SERENITY COUNSELLING SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-21
Last Update Date:2019-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1003146572OtherTHERAPY