Organization Active NPI

Serendipity Psychiatric PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wyomissing, PA
National Provider Identifier
1982598413
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SERENDIPITY PSYCHIATRIC PLLC
Practice address
12 Commerce Dr
Wyomissing, PA 19610-3349
Phone
(484) 509-1177
Fax
(484) 509-0716
NPI assigned
Jun 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Authorized official

Name
Colleen Marshalll
Title
Ceo
Phone
(908) 506-0108

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

12 Commerce Dr
Wyomissing, PA 19610-3349

Mailing address

12 Commerce Dr
Wyomissing, PA 19610-3349
Phone (484) 509-1177

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250912001861 PA Part B Supplier - Clinic/Group Practice 2163925330 Receives reassigned benefits from 2 practitioners
Practice locations: Wyomissing, PA

National Provider Directory

National Provider Directory

Locations

12 Commerce Dr
Wyomissing, PA 19610
Phone (484) 509-1177

12 Commerce Dr
Ste B
Wyomissing, PA 19610
Phone (484) 509-1177

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753401600000",
    "number": "1982598413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 COMMERCE DR",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103349",
            "telephone_number": "484-509-1177",
            "fax_number": "484-509-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 COMMERCE DR",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103349",
            "telephone_number": "484-509-1177",
            "fax_number": "484-509-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENDIPITY PSYCHIATRIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A",
        "authorized_official_last_name": "MARSHALLL",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "908-506-0108"
    },
    "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": []
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; 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.