Provider Demographics
NPI:1083404271
Name:SEROTINY PSYCHOTHERAPY P.L.L.C.
Entity type:Organization
Organization Name:SEROTINY PSYCHOTHERAPY P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMORY
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLANTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-518-4770
Mailing Address - Street 1:1721 10TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1816
Mailing Address - Country:US
Mailing Address - Phone:360-518-4770
Mailing Address - Fax:
Practice Address - Street 1:1721 10TH AVE SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1816
Practice Address - Country:US
Practice Address - Phone:360-518-4770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)