Provider Demographics
NPI:1871318196
Name:SERENITY MINDS LLC
Entity type:Organization
Organization Name:SERENITY MINDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LPCC, LICDC
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROHRBACH
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, LICDC
Authorized Official - Phone:567-207-5377
Mailing Address - Street 1:54 S MARION ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44818-9201
Mailing Address - Country:US
Mailing Address - Phone:567-207-5377
Mailing Address - Fax:888-518-4977
Practice Address - Street 1:54 S MARION ST
Practice Address - Street 2:
Practice Address - City:BLOOMVILLE
Practice Address - State:OH
Practice Address - Zip Code:44818-9201
Practice Address - Country:US
Practice Address - Phone:567-207-5377
Practice Address - Fax:888-518-4977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty