Serenity Youth Services

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SERENITY YOUTH SERVICES

Practice address

1011 Tracy Ave
Duncanville, TX 75137-3550

Phone

(469) 600-6366

Fax

(972) 637-7511

NPI assigned

Apr 8, 2024

Organization subpart

No

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

Authorized official

Name

Lynda Johnson, PSYD. LPCS

Title

Director

Phone

(469) 600-6366

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1700639168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 TRACY AVE",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751373550",
            "telephone_number": "469-600-6366",
            "fax_number": "972-637-7511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 TRACY AVE",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751373550",
            "telephone_number": "469-600-6366",
            "fax_number": "972-637-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY YOUTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "469-600-6366",
        "authorized_official_credential": "PSYD. LPCS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.