Provider Demographics
NPI:1770726051
Name:SERENITY FAMILY COUNSELING SERVICES
Entity type:Organization
Organization Name:SERENITY FAMILY COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHALANDA
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:WEEMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:703-530-8055
Mailing Address - Street 1:3146 GOLANSKY BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-4261
Mailing Address - Country:US
Mailing Address - Phone:703-530-8055
Mailing Address - Fax:
Practice Address - Street 1:3146 GOLANSKY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-4261
Practice Address - Country:US
Practice Address - Phone:703-530-8055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-15
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040069491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty