Serenity Recovery Center

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

SERENITY RECOVERY CENTER

Practice address

2080 11TH Ave E
North St Paul, MN 55109-5112

Phone

(612) 298-2987

NPI assigned

Sep 21, 2022

Organization subpart

No

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

Authorized official

Name

Fartun Wardere, ADC-TNPI 1700514270

Title

Counselor

Phone

(612) 298-2987

Specialties & licenses 1

Addresses

Other names 1

• Serenity Recovery Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fartun Wardere

  • Behavior Technician
  • Oakdale, MN
  • NPI 1700514270
  NPD Authorized official

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1043933344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 11TH AVE E",
            "city": "NORTH ST PAUL",
            "state": "MN",
            "postal_code": "551095112",
            "telephone_number": "612-298-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 11TH AVE E",
            "city": "NORTH ST PAUL",
            "state": "MN",
            "postal_code": "551095112",
            "telephone_number": "612-298-2987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "WARDERE",
        "authorized_official_first_name": "FARTUN",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "612-298-2987",
        "authorized_official_credential": "ADC-T"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natalie Rose Schwartz
• Michael Anthony Schwieters, MSED LP
• Charlene Lee Scott
• Lawrence Lowell Sedlacek, MA, LPCC
• Eryn Segar
• Emily Shearer
• Traci Lee Smith
• Kelsey Soderberg
• Jesse St. John
• Sidney Marie Stanislaw

• Addiction (Substance Use Disorder) Counselor in North St Paul, MN
• Providers in North St Paul, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.