Provider Demographics
NPI:1881454056
Name:BLUE SERENITY COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:BLUE SERENITY COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFREY
Authorized Official - Suffix:
Authorized Official - Credentials:LLC
Authorized Official - Phone:724-759-3550
Mailing Address - Street 1:540 BAILEYS RUN RD
Mailing Address - Street 2:
Mailing Address - City:TARENTUM
Mailing Address - State:PA
Mailing Address - Zip Code:15084-3735
Mailing Address - Country:US
Mailing Address - Phone:724-759-3550
Mailing Address - Fax:
Practice Address - Street 1:100 TARENTUM BRIDGE RD # 1011
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-4670
Practice Address - Country:US
Practice Address - Phone:412-229-7453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty