NPIMap

Organization Active NPI

Serenity Therapeutic Center LLC

  • Mental Health Counselor
  • Henderson, NV
National Provider Identifier
1386369841
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SERENITY THERAPEUTIC CENTER LLC
Practice address
2715 Briarcliff Ave
Henderson, NV 89074-1210
Phone
(702) 412-9077
NPI assigned
Oct 7, 2022
Last updated
Oct 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Authorized official

Name
Dorine HaynesNPI 1558805978
Title
Owner
Phone
(702) 412-9077

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Mental Health Counselor 101YM0800X NU Primary
Clinical Social Worker 1041C0700X NU

Addresses

Primary practice location

2715 Briarcliff Ave
Henderson, NV 89074-1210

Mailing address

2715 Briarcliff Ave
Henderson, NV 89074-1210
Phone (702) 412-9077

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL serenityistherapeutic@gmail.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250610004166 NV Part B Supplier - Clinic/Group Practice 1052821865 Receives reassigned benefits from 2 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1665100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665100800000",
    "number": "1386369841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 BRIARCLIFF AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890741210",
            "telephone_number": "702-412-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 BRIARCLIFF AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890741210",
            "telephone_number": "702-412-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY THERAPEUTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-07",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "DORINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-412-9077"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "serenityistherapeutic@gmail.com",
            "affiliation": "N",
            "address_1": "2715 Briarcliff Ave",
            "city": "Henderson",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890741210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.