My Serenity My Life PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MY SERENITY MY LIFE PLLC

Practice address

740 Center St
Clio, MI 48420-1148

Phone

(810) 309-5362

NPI assigned

Apr 30, 2019

Organization subpart

No

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

Authorized official

Name

Lynn P Proctor, LLMSW

Title

Social Worker

Phone

(810) 309-5362

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556582400000",
    "number": "1952965477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 CHATEAU DR",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485041623",
            "telephone_number": "810-309-5362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 CENTER ST",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484201148",
            "telephone_number": "810-309-5362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY SERENITY MY LIFE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-30",
        "last_updated": "2019-04-30",
        "status": "A",
        "authorized_official_last_name": "PROCTOR",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "810-309-5362",
        "authorized_official_credential": "LLMSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Clio, MI
• Providers in Clio, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.