Active NPI
Serenity Place Intervention Center, Inc
- Mental Health Counselor
- Raleigh, NC
National Provider Identifier
1619799442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- SERENITY PLACE INTERVENTION CENTER, INC
- Practice address
- 140 Mine Lake CT Ste 100
Raleigh, NC 27615-6417 - Phone
- (919) 847-3309
- Fax
- (919) 518-8295
- NPI assigned
- Oct 31, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Peter Onuzulike
- Title
- President/Ceo
- Phone
- (919) 395-5262
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary | ||
| Professional Counselor | 101YP2500X | |||
| Clinical Social Worker | 1041C0700X | |||
| Marriage & Family Therapist | 106H00000X | |||
| Behavior Technician | 106S00000X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Contractor | 171W00000X | |||
| Driver | 172A00000X | |||
| Peer Specialist | 175T00000X | |||
| Case Management Agency | 251B00000X | |||
| Home Health Agency | 251E00000X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Technician | 374700000X | |||
| Home Health Aide | 374U00000X | |||
| Nurse's Aide | 376K00000X |
Addresses
Primary practice location
140 Mine Lake CT Ste 100
Raleigh, NC 27615-6417
Mailing address
140 Mine Lake CT Ste 100
Raleigh, NC 27615-6417
Phone (919) 847-3309
Other names 1
- SPIC MEDICAL EQUIPMENT SUPPLY
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Raleigh, NC
- NPI 1376073056
Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730332800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1730419200000",
"number": "1619799442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 MINE LAKE CT STE 100",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276156417",
"telephone_number": "919-847-3309",
"fax_number": "919-518-8295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 MINE LAKE CT STE 100",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276156417",
"telephone_number": "919-847-3309",
"fax_number": "919-518-8295"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SERENITY PLACE INTERVENTION CENTER, INC",
"organizational_subpart": "NO",
"enumeration_date": "2024-10-31",
"last_updated": "2024-11-01",
"certification_date": "2024-11-01",
"status": "A",
"authorized_official_last_name": "ONUZULIKE",
"authorized_official_first_name": "PETER",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "919-395-5262",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "171W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Contractor",
"state": null,
"license": null,
"primary": false
},
{
"code": "172A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Driver",
"state": null,
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "374700000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "376K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse's Aide",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "SPIC MEDICAL EQUIPMENT SUPPLY",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.