Organization Active NPI

Serenita Wellness LLC

  • Clinical Social Worker
  • Seymour, CT
National Provider Identifier
1568007474
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SERENITA WELLNESS LLC
Practice address
100 Bank St Ste 104
Seymour, CT 06483-2806
Phone
(203) 828-0704
NPI assigned
Nov 14, 2019
Last updated
Feb 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Authorized official

Name
Melissa Trinci, CEO
Title
Managing Partner
Phone
(203) 278-6042

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

100 Bank St Ste 104
Seymour, CT 06483-2806

Mailing address

151 S Main St
Seymour, CT 06483-3346

Other practice location 1

151 S Main St # SS
Seymour, CT 06483-3346
Phone (203) 278-6042

Other practice location 2

4 Research Dr
Shelton, CT 06484-6280
Phone (203) 828-0704

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200513002089 CT Part B Supplier - Clinic/Group Practice 4789015488 Receives reassigned benefits from 2 practitioners
Practice locations: Seymour, CT

National Provider Directory

National Provider Directory

Locations

17 Westerman Ave
Ste 2
Seymour, CT 06483
Phone (203) 828-0704

Practitioners & affiliated clinicians

Practitioners 3

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": "1573689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676419200000",
    "number": "1568007474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 S MAIN ST",
            "city": "SEYMOUR",
            "state": "CT",
            "postal_code": "064833346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BANK ST STE 104",
            "city": "SEYMOUR",
            "state": "CT",
            "postal_code": "064832806",
            "telephone_number": "203-828-0704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 S Main St # SS",
            "address_purpose": "LOCATION",
            "city": "Seymour",
            "state": "CT",
            "postal_code": "064833346",
            "country_code": "US",
            "telephone_number": "203-278-6042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 Research Dr",
            "address_purpose": "LOCATION",
            "city": "Shelton",
            "state": "CT",
            "postal_code": "064846280",
            "country_code": "US",
            "telephone_number": "203-828-0704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SERENITA WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-14",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A",
        "authorized_official_last_name": "TRINCI",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "203-278-6042",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.