NPIMap

Organization Active NPI

Serenity Experience Healing Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
National Provider Identifier
1841054772
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SERENITY EXPERIENCE HEALING CENTER
Practice address
4920 Belair Rd
Baltimore, MD 21206-5601
Phone
(410) 585-7227
NPI assigned
Feb 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Authorized official

Name
Rosalyn Contina Fulton, LCPC LCADC RPSNPI 1366977514
Title
Ceo/Founder
Phone
(410) 585-7227

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

4920 Belair Rd
Baltimore, MD 21206-5601

Mailing address

4920 Belair Rd
Baltimore, MD 21206-5601
Phone (410) 585-7227

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1841054772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 BELAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212065601",
            "telephone_number": "410-585-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 BELAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212065601",
            "telephone_number": "410-585-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY EXPERIENCE HEALING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-11",
        "status": "A",
        "authorized_official_last_name": "FULTON",
        "authorized_official_first_name": "ROSALYN",
        "authorized_official_middle_name": "CONTINA",
        "authorized_official_title_or_position": "CEO/FOUNDER",
        "authorized_official_telephone_number": "410-585-7227",
        "authorized_official_credential": "LCPC LCADC RPS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

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