NPIMap

Organization Active NPI

Serenity Counseling Solutions, LLC

  • Professional Counselor
  • Mentor, OH
National Provider Identifier
1508319971
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C.1300702 Issued in OH
Legal business name
SERENITY COUNSELING SOLUTIONS, LLC
Practice address
7547 Mentor Ave
Suite 310
Mentor, OH 44060-5438
Phone
(440) 479-5145
NPI assigned
Aug 2, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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

Authorized official

Name
Jessica M Wiener, LPCNPI 1205236593
Title
Owner
Phone
(440) 479-5145

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
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X C.1300702 OH Primary

Addresses

Primary practice location

7547 Mentor Ave
Suite 310
Mentor, OH 44060-5438

Mailing address

7547 Mentor Ave
Suite 310
Mentor, OH 44060-5438
Phone (440) 479-5145

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190614002074 OH Part B Supplier - Clinic/Group Practice 9335472885 Receives reassigned benefits from 1 practitioner
Practice locations: Mentor, OH

National Provider Directory

National Provider Directory

Locations

7547 Mentor Ave
Ste 310
Mentor, OH 44060
Phone (440) 299-7854

8334 Tyler Blvd
Mentor, OH 44060
Phone (440) 299-7854

Practitioners & affiliated clinicians

Practitioners 6

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": "1470096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470096000000",
    "number": "1508319971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7547 MENTOR AVE",
            "address_2": "SUITE 310",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605438",
            "telephone_number": "440-479-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7547 MENTOR AVE",
            "address_2": "SUITE 310",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605438",
            "telephone_number": "440-479-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY COUNSELING SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-08-02",
        "status": "A",
        "authorized_official_last_name": "WIENER",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-479-5145",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.1300702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; 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.