Provider Demographics
NPI:1649081340
Name:SERENE INNOVATIONS COUNSELING LLC
Entity type:Organization
Organization Name:SERENE INNOVATIONS COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:UTRIE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:920-296-6599
Mailing Address - Street 1:6622 OFFSHORE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-4236
Mailing Address - Country:US
Mailing Address - Phone:608-571-2536
Mailing Address - Fax:920-887-8839
Practice Address - Street 1:6622 OFFSHORE DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-4236
Practice Address - Country:US
Practice Address - Phone:920-296-6599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-14
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty