Provider Demographics
NPI:1871212282
Name:SERENITY COUNSELING & WELLNESS, LLC
Entity type:Organization
Organization Name:SERENITY COUNSELING & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CANDRA
Authorized Official - Middle Name:GILLIARD
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:843-212-6499
Mailing Address - Street 1:PO BOX 2814
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29484-2814
Mailing Address - Country:US
Mailing Address - Phone:843-212-6499
Mailing Address - Fax:
Practice Address - Street 1:597 OLD MOUNT HOLLY RD STE 203E
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-2832
Practice Address - Country:US
Practice Address - Phone:843-212-6499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2023-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health