Serenity Health Az PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SERENITY HEALTH AZ PLLC

Practice address

4360 San Felipe Rd
Bullhead City, AZ 86429-7715

Phone

(702) 630-0883

NPI assigned

Oct 25, 2019

Last updated

Oct 25, 2019By 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

Gaby Cruz, MS., MFT- INTERN

Title

Executive Director/ Owner

Phone

(702) 815-1550

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571961600000",
    "number": "1730722315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4360 SAN FELIPE RD",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864297715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 SAN FELIPE RD",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864297715",
            "telephone_number": "702-630-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HEALTH AZ PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-25",
        "last_updated": "2019-10-25",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "GABY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/ OWNER",
        "authorized_official_telephone_number": "702-815-1550",
        "authorized_official_credential": "MS., MFT- INTERN"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; 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.