Serenity and Sage Counseling, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SERENITY AND SAGE COUNSELING, LLC

Practice address

3739 Wilkens Ave
Baltimore, MD 21229-5035

Phone

(443) 267-7775

NPI assigned

May 17, 2021

Organization subpart

No

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

Authorized official

Name

Keisha BroylesNPI 1689806929

Title

Clinical Therapist

Phone

(443) 267-7775

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Keisha Broyles Doing business as

Electronic endpoints 1

Locations

Practitioners 1

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

• Keisha Lynne Broyles, LCSW-C

  • Clinical Social Worker
  • Halethorpe, MD
  • NPI 1689806929
  NPD Authorized official

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621209600000",
    "number": "1306410196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3739 WILKENS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295035",
            "telephone_number": "443-267-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3739 WILKENS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295035",
            "telephone_number": "443-267-7775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 E 25th St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212185281",
            "country_code": "US",
            "telephone_number": "443-267-7775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SERENITY AND SAGE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A",
        "authorized_official_last_name": "BROYLES",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "443-267-7775"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1689806929",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Baltimore",
            "affiliation": "N",
            "address_1": "3739 Wilkens Ave",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212295035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Keisha Broyles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mara Alexandra Serbanescu, M.D.
• Serena R. Nolan, M.D., PA
• Serene Living
• Serenity and Grace Healthcare LLC
• Serenity and Grace Healthcare LLC
• Serenity and Wellness Clinic
• Serenity and Wellness Clinic
• Serenity and Wellness Clinic
• Serenity and Wellness Clinic
• Serenity Angel of Hopes Home & Healthcare Services LLC

• Clinical Social Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.