NPIMap

Organization Active NPI

Serenity Therapeutic Counseling & Addiction Services LLC

  • Clinical Social Worker
  • Clinton Township, MI
National Provider Identifier
1225810666
Registry record updated Oct 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SERENITY THERAPEUTIC COUNSELING & ADDICTION SERVICES LLC
Practice address
42627 Garfield Rd Ste 214
Clinton Township, MI 48038-5032
Phone
(586) 310-8158
NPI assigned
Oct 19, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2023

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

Authorized official

Name
Jennifer JacksonNPI 1548041288
Title
Owner
Phone
(586) 310-8158

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

42627 Garfield Rd Ste 214
Clinton Township, MI 48038-5032

Mailing address

42627 Garfield Rd Ste 214
Clinton Township, MI 48038-5032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240918000939 MI Part B Supplier - Clinic/Group Practice 4880135896 Receives reassigned benefits from 4 practitioners
Practice locations: Clinton Township, MI; Farmington Hills, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1697673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697846400000",
    "number": "1225810666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42627 GARFIELD RD STE 214",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42627 GARFIELD RD STE 214",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385032",
            "telephone_number": "586-310-8158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY THERAPEUTIC COUNSELING & ADDICTION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-19",
        "last_updated": "2023-10-21",
        "certification_date": "2023-10-21",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-310-8158"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.