Serenity Integrated Practice Sip LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SERENITY INTEGRATED PRACTICE SIP LLC

Practice address

700 Bryden Rd # 122
Columbus, OH 43215-4839

Phone

(146) 787-5183

NPI assigned

Jan 12, 2023

Organization subpart

No

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

Authorized official

Name

Tarsicio Gacheru, CNP

Title

Ceo

Phone

(146) 531-6583

Specialties & licenses 5

Addresses

Electronic endpoints 1

Practitioners 1

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

• Zara Khan, QBHS

  • Case Manager/Care Coordinator
  • Hilliard, OH
  • NPI 1871082321
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1649984741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5719 LAURA LN",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430267339",
            "telephone_number": "614-961-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 BRYDEN RD # 122",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154839",
            "telephone_number": "146-787-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY INTEGRATED PRACTICE SIP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-12",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "GACHERU",
        "authorized_official_first_name": "TARSICIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "146-531-6583",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SIP700@OUTLOOK.COM",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "address_1": "700 Bryden Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432154839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Serenity Homecare Inc
• Serenity Services Agency LLC
• Shane A Serfling, DO
• Rebecca Ann Serfozo, LSW
• Edwin Jesus Serrano Lopez, MD
• Elizabeth Sertell, MSW, LISW, MBA, CDCA

• Community/Behavioral Health Agency in Columbus, OH
• Providers in Columbus, OH by specialty
• Community/Behavioral Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.

Verify at the official NPI Registry.