Provider Demographics
NPI:1457978900
Name:PEAK SERENITY COUNSELING & NUTRITION LLC
Entity Type:Organization
Organization Name:PEAK SERENITY COUNSELING & NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTA
Authorized Official - Middle Name:L
Authorized Official - Last Name:STUDER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, RDN, NCC
Authorized Official - Phone:330-703-0435
Mailing Address - Street 1:808 S ARLINGTON MILL DR APT 204
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-6019
Mailing Address - Country:US
Mailing Address - Phone:330-703-0435
Mailing Address - Fax:
Practice Address - Street 1:1942 BROADWAY STE 314C
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5233
Practice Address - Country:US
Practice Address - Phone:330-703-0435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1437621265Medicaid