Provider Demographics
NPI:1962083469
Name:DRUM, SERENITY DAWN (LCSW)
Entity type:Individual
Prefix:
First Name:SERENITY
Middle Name:DAWN
Last Name:DRUM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SERENITY
Other - Middle Name:DAWN
Other - Last Name:LEDVINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:820 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BLANCO
Mailing Address - State:TX
Mailing Address - Zip Code:78606-4914
Mailing Address - Country:US
Mailing Address - Phone:830-554-0098
Mailing Address - Fax:
Practice Address - Street 1:820 6TH ST
Practice Address - Street 2:
Practice Address - City:BLANCO
Practice Address - State:TX
Practice Address - Zip Code:78606-4914
Practice Address - Country:US
Practice Address - Phone:830-554-0098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-16
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX538351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty