Serene Concepts PC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

SERENE CONCEPTS PC

Doing business as

Serene Behavioral Concepts

Practice address

500 Lanier Ave W Ste 801G
Fayetteville, GA 30214-7642

Phone

(302) 455-2002

NPI assigned

Sep 19, 2019

Organization subpart

No

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

Authorized official

Name

Mfon Malachy Inyang, MD

Title

Ceo

Phone

(248) 506-6867

Specialties & licenses 2

Addresses

Other names 1

• Serene Behavioral Concepts Doing business as

Locations

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568851200000",
    "number": "1265082341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1149",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302146149",
            "telephone_number": "248-506-6867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LANIER AVE W STE 801G",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147642",
            "telephone_number": "302-455-2002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "572 Maddox Dr Ste 218",
            "address_purpose": "LOCATION",
            "city": "Ellijay",
            "state": "GA",
            "postal_code": "305406032",
            "country_code": "US",
            "telephone_number": "302-455-2002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SERENE CONCEPTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-19",
        "last_updated": "2019-09-19",
        "status": "A",
        "authorized_official_last_name": "INYANG",
        "authorized_official_first_name": "MFON",
        "authorized_official_middle_name": "MALACHY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-506-6867",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serene Behavioral Concepts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adolescent and Children Mental Health Clinic/Center in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Adolescent and Children Mental Health Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.