Serenity Clinic, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LPC003374 Issued in GA

Legal business name

SERENITY CLINIC, LLC

Practice address

362 Racetrack Rd
McDonough, GA 30252-1022

Phone

(678) 640-7141

NPI assigned

Jan 15, 2012

Organization subpart

No

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

Authorized official

Name

Patricia Calloway, LPC

Title

Owner/Professional Counselor

Phone

(678) 640-7141

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1326585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326585600000",
    "number": "1083985543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 RACETRACK RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302521022",
            "telephone_number": "678-640-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 RACETRACK RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302521022",
            "telephone_number": "678-640-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-15",
        "last_updated": "2012-01-15",
        "status": "A",
        "authorized_official_last_name": "CALLOWAY",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER/PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "678-640-7141",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "LPC003374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in McDonough, GA
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• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2012; 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.