NPIMap

Organization Active NPI

Serenity Psychodynamics, LLC

  • Psychologist
  • Omaha, NE
National Provider Identifier
1003261520
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
866 Issued in NE
Legal business name
SERENITY PSYCHODYNAMICS, LLC
Practice address
11605 Arbor St
Suite 102
Omaha, NE 68144-2982
Phone
(402) 330-4700
Fax
(402) 330-8815
NPI assigned
May 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kathleen Kallstrom-Schreckengost, PSYD
Title
Owner
Phone
(402) 330-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 866 NE Primary

Addresses

Primary practice location

11605 Arbor St
Suite 102
Omaha, NE 68144-2982

Mailing address

11605 Arbor St
Suite 102
Omaha, NE 68144-2982
Phone (402) 330-4700

National Provider Directory

National Provider Directory

Locations

11605 Arbor St
Ste 102
Omaha, NE 68144
Phone (402) 330-0960

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462233600000",
    "number": "1003261520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11605 ARBOR ST",
            "address_2": "SUITE 102",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442982",
            "telephone_number": "402-330-4700",
            "fax_number": "402-330-8815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11605 ARBOR ST",
            "address_2": "SUITE 102",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442982",
            "telephone_number": "402-330-4700",
            "fax_number": "402-330-8815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY PSYCHODYNAMICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-05-03",
        "status": "A",
        "authorized_official_last_name": "KALLSTROM-SCHRECKENGOST",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-330-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NE",
            "license": "866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.