Provider Demographics
NPI:1215475694
Name:SERENITY POINT COUNSELING LLC
Entity type:Organization
Organization Name:SERENITY POINT COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCWILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:814-795-4034
Mailing Address - Street 1:312 CHESTNUT ST STE 113
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-3206
Mailing Address - Country:US
Mailing Address - Phone:814-795-4034
Mailing Address - Fax:
Practice Address - Street 1:312 CHESTNUT ST STE 113
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3206
Practice Address - Country:US
Practice Address - Phone:814-795-4034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007048101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC007048OtherSTATE LICENSE LPC
PA1245636059OtherNPI PROVIDER INDIVIDUAL