Serenity Point Counseling Services

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

SERENITY POINT COUNSELING SERVICES

Practice address

705 W Rose St Ste 1
Walla Walla, WA 99362-1762

Phone

(509) 529-6036

Fax

(509) 529-6038

NPI assigned

Jan 25, 2007

Organization subpart

No

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

Authorized official

Name

Patrick C Flores, LICSW, CDP

Title

Program Manager, Owner

Phone

(509) 526-6036

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381968000000",
    "number": "1790831600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 W ROSE ST STE 1",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993621762",
            "telephone_number": "509-529-6036",
            "fax_number": "509-529-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 W ROSE ST STE 1",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993621762",
            "telephone_number": "509-529-6036",
            "fax_number": "509-529-6038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY POINT COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2013-10-17",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PROGRAM MANAGER, OWNER",
        "authorized_official_telephone_number": "509-526-6036",
        "authorized_official_credential": "LICSW, CDP"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE PROVIDER ID",
            "identifier": "4486 SE",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1994417",
            "state": "WA"
        }
    ],
    "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 17, 2013; 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.