Provider Demographics
NPI:1902515513
Name:SERENITY WALK COUNSELING SERVICES, LCSW, PLLC
Entity type:Organization
Organization Name:SERENITY WALK COUNSELING SERVICES, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:G
Authorized Official - Last Name:MARTYN-BRUNNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CASAC, CST
Authorized Official - Phone:585-905-5468
Mailing Address - Street 1:10 EAST MAIN STREET
Mailing Address - Street 2:SUITE 210, MAILBOX 4
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564
Mailing Address - Country:US
Mailing Address - Phone:585-905-5468
Mailing Address - Fax:
Practice Address - Street 1:10 EAST MAIN STREET
Practice Address - Street 2:SUITE 210, MAILSLOT 4
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564
Practice Address - Country:US
Practice Address - Phone:585-905-5468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-22
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1366901217OtherINSURANCE