Provider Demographics
NPI:1457077323
Name:SERENITY COUNSELING OF WEST ALABAMA, LLC
Entity Type:Organization
Organization Name:SERENITY COUNSELING OF WEST ALABAMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST/ SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:205-393-7713
Mailing Address - Street 1:10701 MELROSE LN
Mailing Address - Street 2:
Mailing Address - City:COTTONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35453-2363
Mailing Address - Country:US
Mailing Address - Phone:205-393-7713
Mailing Address - Fax:205-469-9343
Practice Address - Street 1:423 SKYLAND BLVD STE A7
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-4000
Practice Address - Country:US
Practice Address - Phone:205-202-0724
Practice Address - Fax:205-469-9343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty