Organization Active NPI

Serenity Psychological Services Inc

  • Clinical Psychologist
  • Lake City, FL
National Provider Identifier
1902059801
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 6932 Issued in FL
Legal business name
SERENITY PSYCHOLOGICAL SERVICES INC
Practice address
560 SW McFarlane Ave
Lake City, FL 32025
Phone
(352) 234-4010
NPI assigned
Oct 23, 2008
Last updated
Sep 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Authorized official

Name
Mrs. April C Roberts, PSY DNPI 1962595843
Title
Psychologist
Phone
(352) 234-4010

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY 6932 FL Primary

Addresses

Primary practice location

560 SW McFarlane Ave
Lake City, FL 32025

Mailing address

PO Box 357757
Gainesville, FL 32635-7757
Phone (352) 234-4010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090414000753 FL Part B Supplier - Clinic/Group Practice 2769539493 Receives reassigned benefits from 1 practitioner
Practice locations: Palatka, FL; Trenton, FL; Mayo, FL; Live Oak, FL; Lake City, FL; Gainesville, FL; Cross City, FL

National Provider Directory

National Provider Directory

Locations

227 SW 62nd Blvd
Gainesville, FL 32607
Phone (352) 331-0601

3324 W University Ave
Unit 241
Gainesville, FL 32607
Phone (352) 234-4010

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630540800000",
    "number": "1902059801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357757",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326357757",
            "telephone_number": "352-234-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 SW MCFARLANE AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "32025",
            "telephone_number": "352-234-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY PSYCHOLOGICAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-23",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "APRIL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "352-234-4010",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PSY D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 6932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.