Organization Active NPI

Serenity Health and Consultation LLC

  • Clinical Social Worker
  • Brenham, TX
National Provider Identifier
1235919325
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SERENITY HEALTH AND CONSULTATION LLC
Practice address
206 W First St Ste D
Brenham, TX 77833-3604
Phone
(281) 702-3353
Fax
(281) 215-3949
NPI assigned
Oct 5, 2023
Last updated
Oct 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Authorized official

Name
Theresa Fawvor, LCSWNPI 1932563764
Title
Owner/LCSW
Phone
(281) 702-3353

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 Worker 1041C0700X NU Primary

Addresses

Primary practice location

206 W First St Ste D
Brenham, TX 77833-3604

Mailing address

300 Cedar Oaks Dr
Brenham, TX 77833-6387
Phone (281) 702-3353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231031003685 TX Part B Supplier - Clinic/Group Practice 0042666778 Receives reassigned benefits from 1 practitioner
Practice locations: Brenham, TX

National Provider Directory

National Provider Directory

Locations

206 W First St
Ste D
Brenham, TX 77833
Phone (281) 702-3353

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1696464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1235919325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CEDAR OAKS DR",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778336387",
            "telephone_number": "281-702-3353",
            "fax_number": "281-215-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W FIRST ST STE D",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778333604",
            "telephone_number": "281-702-3353",
            "fax_number": "281-215-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HEALTH AND CONSULTATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-05",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "FAWVOR",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "OWNER/LCSW",
        "authorized_official_telephone_number": "281-702-3353",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.