Serenity Wellness Centre, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

004722 Issued in PA

Legal business name

SERENITY WELLNESS CENTRE, LLC

Practice address

2011 Cato Ave Ste 201
State College, PA 16801-2765

Phone

(814) 206-7624

Fax

(814) 206-7628

NPI assigned

Oct 1, 2015

Organization subpart

No

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

Authorized official

Name

Nicole C White, M.ED, LPC, DBTCNPI 1003163544

Title

Owner, Counselor, Reiki Master

Phone

(814) 206-7624

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 2

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

• Nicole C White, LPC

  • Professional Counselor
  • State College, PA
  • NPI 1003163544
  Medicare reassignment NPD Authorized official
• Eva M Letwin, MA, M.ED.

  • Mental Health Counselor
  • State College, PA
  • NPI 1912250523

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443657600000",
    "number": "1790155828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 CATO AVE STE 201",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168012765",
            "telephone_number": "814-206-7624",
            "fax_number": "814-206-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 CATO AVE STE 201",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168012765",
            "telephone_number": "814-206-7624",
            "fax_number": "814-206-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY WELLNESS CENTRE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-01",
        "last_updated": "2015-10-01",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER, COUNSELOR, REIKI MASTER",
        "authorized_official_telephone_number": "814-206-7624",
        "authorized_official_credential": "M.ED, LPC, DBTC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "004722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna A Senior, D.M.D
• Paul Richard Sensiba, MD
• Rodney M Sepich, MD
• Tracy C Sepich, OD
• James W Serene, MD
• Abhishek Seth, MD
• Katherine Allison Shaak, LAT, ATC, PES
• Leonard Shamus, NP
• Justine Shaner, PTA
• Shapiro Psychological Services, LLC

• Professional Counselor in State College, PA
• Providers in State College, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.