Provider Demographics
NPI:1972219426
Name:THERAPY WITH SERENITY
Entity type:Organization
Organization Name:THERAPY WITH SERENITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SERENITY
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVERS
Authorized Official - Suffix:
Authorized Official - Credentials:MPS, LPCC, LADC
Authorized Official - Phone:651-419-6967
Mailing Address - Street 1:1041 GRAND AVE STE 135
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-3002
Mailing Address - Country:US
Mailing Address - Phone:651-419-6967
Mailing Address - Fax:
Practice Address - Street 1:180 KELLOGG BLVD E APT 1406
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-1592
Practice Address - Country:US
Practice Address - Phone:651-419-6967
Practice Address - Fax:651-560-3898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty