Organization Active NPI

Serenity Mental Health Therapy LLC

  • Clinical Social Worker
  • Davenport, IA
National Provider Identifier
1396301925
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SERENITY MENTAL HEALTH THERAPY LLC
Practice address
1140 E Kimberly Rd Unit 1B
Davenport, IA 52807-1748
Phone
(563) 370-2214
NPI assigned
May 20, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2019

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

Authorized official

Name
Jennifer Olson, LISW
Title
Owner
Phone
(563) 370-2214

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1140 E Kimberly Rd Unit 1B
Davenport, IA 52807-1748

Mailing address

1140 E Kimberly Rd Unit 1B
Davenport, IA 52807-1748
Phone (563) 370-2214

Other practice location 1

1716 Kenwood Ave
Davenport, IA 52803-3456
Phone (533) 370-2214

Other names 1

  • SERENITY MENTAL HEALTH THERAPY LLC Doing business as

National Provider Directory

National Provider Directory

Locations

1140 E Kimberly Rd
Unit 1B
Davenport, IA 52807
Phone (563) 200-3154

1716 Kenwood Ave
Davenport, IA 52803
Phone (533) 370-2214

Practitioners & affiliated clinicians

Practitioners 1

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": "1558310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558310400000",
    "number": "1396301925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 E KIMBERLY RD UNIT 1B",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071748",
            "telephone_number": "563-370-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 E KIMBERLY RD UNIT 1B",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071748",
            "telephone_number": "563-370-2214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1716 Kenwood Ave",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "IA",
            "postal_code": "528033456",
            "country_code": "US",
            "telephone_number": "533-370-2214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SERENITY MENTAL HEALTH THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-20",
        "last_updated": "2019-05-20",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-370-2214",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SERENITY MENTAL HEALTH THERAPY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.