Serenity Psychiatry and Wellness LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

SERENITY PSYCHIATRY AND WELLNESS LLC

Practice address

156 Dolson Ave Ste 11
Middletown, NY 10940-6560

Phone

(458) 360-2500

NPI assigned

Oct 3, 2024

Last updated

Oct 3, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Pavel Odintsov, NPNPI 1073893178

Title

Manager

Phone

(201) 665-4150

Specialties & licenses 1

Addresses

Locations

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.

• Pavel Odintsov, APN

  • Primary Care Nurse Practitioner
  • New City, NY
  • NPI 1073893178
  NPD Authorized official

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

{
    "created_epoch": "1727913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1932928256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 HILLSDALE AVE",
            "city": "HILLSDALE",
            "state": "NJ",
            "postal_code": "076422212",
            "telephone_number": "201-665-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 DOLSON AVE STE 11",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109406560",
            "telephone_number": "458-360-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY PSYCHIATRY AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-03",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "ODINTSOV",
        "authorized_official_first_name": "PAVEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "201-665-4150",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dhana Selvaraj, MD
• Sundararajan Selvaraj, M.D.
• Sheneka Semple
• Catherine Sendlewski, LMSW
• Selcen Senol, MD
• Eric Jon Dela Sena Sero
• Peter Christian Serrano, RN
• Gurvinder Sethi, MD
• Michel Settles
• Tedhar Setton, MD

• Psychiatric/Mental Health Nurse Practitioner in Middletown, NY
• Providers in Middletown, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.