Provider Demographics
NPI:1801454897
Name:SERENITY COUNSELING
Entity type:Organization
Organization Name:SERENITY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C,MAC,ADS
Authorized Official - Phone:301-722-5500
Mailing Address - Street 1:118 VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2141
Mailing Address - Country:US
Mailing Address - Phone:301-722-5500
Mailing Address - Fax:301-722-0500
Practice Address - Street 1:118 VALLEY ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2141
Practice Address - Country:US
Practice Address - Phone:301-722-5500
Practice Address - Fax:301-722-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDCE600001OtherBLUE CROSS BLUE SHIELD
MD099466900Medicaid