Serenity Support House LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SERENITY SUPPORT HOUSE LLC

Practice address

20101 NW 34TH CT
Miami Gardens, FL 33056-1768

Phone

(518) 300-3693

NPI assigned

Nov 12, 2024

Last updated

Nov 12, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Shataria Bridges-Moss

Title

Administrator

Phone

(518) 300-3693

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1731369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1720802150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20101 NW 34TH CT",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330561768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20101 NW 34TH CT",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330561768",
            "telephone_number": "518-300-3693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY SUPPORT HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "BRIDGES-MOSS",
        "authorized_official_first_name": "SHATARIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "518-300-3693",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Miami Gardens, FL
• Providers in Miami Gardens, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.