Serene Haven Behavioral Clinic LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

SERENE HAVEN BEHAVIORAL CLINIC LLC

Practice address

4301 Waterford Glen Dr
Mansfield, TX 76063-9104

Phone

(469) 694-8001

Fax

(469) 613-4007

NPI assigned

Oct 3, 2023

Organization subpart

No

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

Authorized official

Name

Oredunni Oguntodu

Title

Owner

Phone

(682) 553-8157

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696291200000",
    "number": "1427838747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 WATERFORD GLEN DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 WATERFORD GLEN DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639104",
            "telephone_number": "469-694-8001",
            "fax_number": "469-613-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENE HAVEN BEHAVIORAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A",
        "authorized_official_last_name": "OGUNTODU",
        "authorized_official_first_name": "OREDUNNI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "682-553-8157"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Lynn Selim, MSN, AGACNP-BC, APRN
• Brian Paul Senger, M.D.
• Dilip Kumar Sengupta, M.D.
• Papiya Sengupta, MD
• Sengupta, PLLC
• Serenity Transportation LLC (Serenity Transport LLC)
• Julie C Serviss, MS CCC-SLP
• Mohammad O Seth, MD
• Mikhail Cianna Seymour, PA-C
• Tom Shafer, OT

• Psychiatric/Mental Health Nurse Practitioner in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.