Serenity Therapeutic Counseling Services

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC4153 Issued in MD

Legal business name

SERENITY THERAPEUTIC COUNSELING SERVICES

Practice address

1612 McGuckian Ave Suite 3
Annapolis, MD 21401-4024

Phone

(443) 333-9340

NPI assigned

Mar 15, 2012

Organization subpart

No

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

Authorized official

Name

Kendra Lorraine Jackson, LCPC

Title

Clinical Director/Therapist

Phone

(443) 333-9340

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1331769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1881969459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 MCGUCKIAN AVE 110",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "443-333-9340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 MCGUCKIAN AVE SUITE 3",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214014024",
            "telephone_number": "443-333-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY THERAPEUTIC COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-15",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/THERAPIST",
        "authorized_official_telephone_number": "443-333-9340",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC4153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0459291-00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neha Priyavadan Serrano, MD
• Andrew Michael Servinsky, O.D.
• Servitium Med MD, LLC
• Margaret Kathryn Seuss, CRNP
• Emily Marie Sewell, D.D.S.

• Professional Counselor in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.