Organization Active NPI

Serenityonwheels, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Ottawa, IL
National Provider Identifier
1154538510
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
6878 Issued in IL
Legal business name
SERENITYONWHEELS, INC.
Practice address
Serenity on Wheels, Inc. 630 Columbus Street
Ste # 214
Ottawa, IL 61350
Phone
(815) 431-8206
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Kathleen Shea, LCPC CADC
Title
Counselor
Phone
(815) 431-8206

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 6878 IL Primary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X IL

Addresses

Primary practice location

Serenity on Wheels, Inc. 630 Columbus Street
Ste # 214
Ottawa, IL 61350

Mailing address

630 Columbus Street
Ste # 214
Ottawa, IL 61350
Phone (815) 431-8206

Other identifiers 1

IdentifierTypeStateIssuer
6878OtherILCADC

Other names 1

  • No Doing business as

National Provider Directory

National Provider Directory

Locations

630 Columbus St
Ste 214
Ottawa, IL 61350
Phone (815) 431-8206

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1154538510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 COLUMBUS STREET",
            "address_2": "STE # 214",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "61350",
            "telephone_number": "815-431-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SERENITY ON WHEELS, INC. 630 COLUMBUS STREET",
            "address_2": "STE # 214",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "61350",
            "telephone_number": "815-431-8206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITYONWHEELS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "SHEA",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "815-431-8206",
        "authorized_official_credential": "LCPC CADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "6878",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CADC",
            "identifier": "6878",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "No",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ottawa, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.