SERENITY COUNSELING SERVICES PA NPI 1275689812

NPI Information

NPI: 1275689812
Provider Name: SERENITY COUNSELING SERVICES PA
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
500 NW DIXIE HWY
SUITE 102
STUART, FL
ZIP 34994
Phone: (772) 692-8585
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SERENITY COUNSELING SERVICES PA is a rehabilitation and substance use disorder clinic center in Stuart, FL. SERENITY COUNSELING SERVICES PA NPI is 1275689812. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

500 NW DIXIE HWY
SUITE 102
STUART, FL
ZIP 34994
Phone: (772) 692-8585
Fax: (772) 692-5651

The provider's authorized official is Gilda G Broadwell .
The authorized official title is Psychologist and has the following contact phone number (772) 692-8585.

The enumeration date for this NPI number is 1/26/2007 and was last updated on 10/23/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103T00000X	Psychologist		PY5591	FLORIDA	No
2	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	1943AD620400	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	15-43-AD-6204-00	OTHER	FLORIDA	C&F SUB ABUSE COUNSELING
2	00039394	MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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