Journey 2 Serenity, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

JOURNEY 2 SERENITY, LLC

Practice address

99 Main St Ste 213
Nyack, NY 10960-3109

Phone

(917) 309-9184

Fax

(845) 267-0030

NPI assigned

Jan 30, 2020

Organization subpart

No

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

Authorized official

Name

Carmen Nieves-Pacheco, CSWNPI 1326599879

Title

Owner

Phone

(917) 309-9184

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Carmen Nieves-Pacheco

  • Clinical Social Worker
  • Congers, NY
  • NPI 1326599879
  NPD Authorized official

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1881225688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 MAIN ST STE 213",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109603109",
            "telephone_number": "917-309-9184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 MAIN ST STE 213",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109603109",
            "telephone_number": "917-309-9184",
            "fax_number": "845-267-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOURNEY 2 SERENITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "NIEVES-PACHECO",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-309-9184",
        "authorized_official_credential": "CSW"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederick Lee Jones
• Ramona Jones
• Victoria Jones
• Natalie Lourdes Joseph, C.O.T.A.
• Patricia K. Joseph, M.D.
• Jins Joy, RN
• Susan Juechter
• Zena Justice, CRNA
• Besher Kabak, MD
• Christopher J Kaczmarski, M.D.

• Specialist in Nyack, NY
• Providers in Nyack, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.