Provider Demographics
NPI:1063875789
Name:SERENITY COUNSELING & WELLNESS, INC
Entity type:Organization
Organization Name:SERENITY COUNSELING & WELLNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNESE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC
Authorized Official - Phone:601-420-2210
Mailing Address - Street 1:209 PARK PLACE CV
Mailing Address - Street 2:SUITE E
Mailing Address - City:PEARL
Mailing Address - State:MS
Mailing Address - Zip Code:39208-8948
Mailing Address - Country:US
Mailing Address - Phone:601-420-2210
Mailing Address - Fax:601-420-2210
Practice Address - Street 1:209 PARK PLACE CV
Practice Address - Street 2:SUITE E
Practice Address - City:PEARL
Practice Address - State:MS
Practice Address - Zip Code:39208-8948
Practice Address - Country:US
Practice Address - Phone:601-420-2210
Practice Address - Fax:601-420-2210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1817101YP2500X
LA2783101YP2500X
MS1469101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty