NPIMap

Organization Active NPI

Serenity Consultants, LLC

  • Clinical Social Worker
  • Pooler, GA
National Provider Identifier
1437658762
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004373 Issued in GA
Legal business name
SERENITY CONSULTANTS, LLC
Practice address
1018 US Highway 80 W Ste 702
Pooler, GA 31322-1606
Phone
(912) 349-2969
Fax
(912) 349-2983
NPI assigned
Feb 1, 2018
Last updated
Oct 4, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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

Authorized official

Name
Mrs. Ellisha Michelle Jones, LCSWNPI 1639274889
Title
Clinical Director
Phone
(912) 247-6482

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X CSW004373 GA Primary

Addresses

Primary practice location

1018 US Highway 80 W Ste 702
Pooler, GA 31322-1606

Mailing address

55 Winslow Cir
Savannah, GA 31407-4946
Phone (912) 247-6482

Other practice location 1

432 US Highway 80 W
Pooler, GA 31322-2510
Phone (912) 247-6482

Other identifiers 1

IdentifierTypeStateIssuer
CSW004373OtherGAGA STATE LICENSE

National Provider Directory

National Provider Directory

Locations

1716 E US Highway 80
Ste D
Bloomingdale, GA 31302

1716 E US Highway 80
#B
Bloomingdale, GA 31302

432 US Highway 80 W
Pooler, GA 31322
Phone (912) 247-6482

1018 US Highway 80 W
Ste 702
Pooler, GA 31322
Phone (912) 349-2969

Practitioners & affiliated clinicians

Practitioners 4

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": "1517443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538611200000",
    "number": "1437658762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WINSLOW CIR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314074946",
            "telephone_number": "912-247-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 US HIGHWAY 80 W STE 702",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313221606",
            "telephone_number": "912-349-2969",
            "fax_number": "912-349-2983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "432 US Highway 80 W",
            "address_purpose": "LOCATION",
            "city": "Pooler",
            "state": "GA",
            "postal_code": "313222510",
            "country_code": "US",
            "telephone_number": "912-247-6482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SERENITY CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-10-04",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ELLISHA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "912-247-6482",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA STATE LICENSE",
            "identifier": "CSW004373",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; 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.