Provider Demographics
NPI:1831799246
Name:SERENITY SPRINGS CLINICAL COUNSELING LLC
Entity type:Organization
Organization Name:SERENITY SPRINGS CLINICAL COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CLINICAL COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:614-537-7426
Mailing Address - Street 1:5913 PINEVILLE DR
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-2568
Mailing Address - Country:US
Mailing Address - Phone:614-537-7426
Mailing Address - Fax:
Practice Address - Street 1:430 SALT MEADOW CIR UNIT 303
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1772
Practice Address - Country:US
Practice Address - Phone:614-537-7426
Practice Address - Fax:844-813-5222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1073061149OtherNPI