Organization Active NPI

Serene Soul Therapy, LLC

  • Clinical Social Worker
  • Nichols, SC
National Provider Identifier
1487530739
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SERENE SOUL THERAPY, LLC
Practice address
2381 Carolina Rd
Nichols, SC 29581-4641
Phone
(317) 717-2769
NPI assigned
Aug 13, 2025
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Valerie Ann Hodges, LISW-CPNPI 1205568375
Title
Owner
Phone
(317) 717-2769

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20260209000447 SC Part B Supplier - Clinic/Group Practice 4880173046 Receives reassigned benefits from 1 practitioner
Practice locations: North Myrtle Beach, SC

National Provider Directory

National Provider Directory

Locations

9821 S Highway 905
Ste A
Longs, SC 29568
Phone (440) 470-8298

2423 Highway 17 S
#22
North Myrtle Beach, SC 29582
Phone (440) 470-8298

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

2381 Carolina Rd
Nichols, SC 29581-4641

Mailing address

2381 Carolina Rd
Nichols, SC 29581-4641

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 2, 2025.

{
    "created_epoch": "1755043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1487530739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2381 CAROLINA RD",
            "city": "NICHOLS",
            "state": "SC",
            "postal_code": "295814641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2381 CAROLINA RD",
            "city": "NICHOLS",
            "state": "SC",
            "postal_code": "295814641",
            "telephone_number": "317-717-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENE SOUL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-717-2769",
        "authorized_official_credential": "LISW-CP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nichols, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.