Provider Demographics
NPI:1487530739
Name:SERENE SOUL THERAPY, LLC
Entity type:Organization
Organization Name:SERENE SOUL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CP
Authorized Official - Phone:317-717-2769
Mailing Address - Street 1:2381 CAROLINA RD
Mailing Address - Street 2:
Mailing Address - City:NICHOLS
Mailing Address - State:SC
Mailing Address - Zip Code:29581-4641
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2381 CAROLINA RD
Practice Address - Street 2:
Practice Address - City:NICHOLS
Practice Address - State:SC
Practice Address - Zip Code:29581-4641
Practice Address - Country:US
Practice Address - Phone:317-717-2769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty