Provider Demographics
NPI:1003204439
Name:SERENITY CARE COUNSELING
Entity type:Organization
Organization Name:SERENITY CARE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RYSHEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:WYNDER-PRESTON
Authorized Official - Suffix:
Authorized Official - Credentials:LSW, SOCIAL WORKER
Authorized Official - Phone:215-617-8519
Mailing Address - Street 1:3331 W ALLEGHENY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-1014
Mailing Address - Country:US
Mailing Address - Phone:215-617-8519
Mailing Address - Fax:
Practice Address - Street 1:3331 W ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132-1014
Practice Address - Country:US
Practice Address - Phone:215-617-8519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-07
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1822022251C00000X, 251E00000X, 251G00000X, 251S00000X, 253Z00000X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care