Individual provider Active NPI

Nina Serene Golemi, MA, LPC

  • Mental Health Counselor
  • Watertown, WI
National Provider Identifier
1962913012
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7351-125 Issued in WI
Practice address
300 N 3Rd St Ste 112
Watertown, WI 53094-3723
Phone
(920) 545-4357
NPI assigned
Oct 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 7351-125 WI Primary

Addresses

Primary practice location

300 N 3Rd St Ste 112
Watertown, WI 53094-3723

Mailing address

818 West Street
Suite 814
Watertown, WI 53094-3608
Phone (920) 248-0578

Other practice location 1

3505 N 124th St
Brookfield, WI 53005-2489
Phone (414) 436-7303 ext. 112

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nina@serenitytherapyclinic.com Direct Serenity Mental Health Services, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
7351-125WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Mental Health Services, LLC Mental Health CurrentSince Jan 12, 2020 Accepting new patients
Inner Haven Wellness LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

401 Charmany Dr
Ste 320
Madison, WI 53719
Phone (608) 400-1951

818 West St
Ste 814
Watertown, WI 53094
Phone (920) 306-2174

300 N 3rd St
Ste 112
Watertown, WI 53094
Phone (920) 545-4357

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1962913012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 WEST STREET",
            "address_2": "SUITE 814",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530943608",
            "telephone_number": "920-248-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N 3RD ST STE 112",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530943723",
            "telephone_number": "920-545-4357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3505 N 124th St",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530052489",
            "country_code": "US",
            "telephone_number": "414-436-7303 x112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLEMI",
        "first_name": "NINA",
        "middle_name": "SERENE",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "7351-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nina@serenitytherapyclinic.com",
            "affiliation": "Y",
            "endpointDescription": "Email Address",
            "affiliationName": "Serenity Mental Health Services, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "300 N 3rd St Ste 112",
            "city": "Watertown",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530943723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.