Provider Demographics
NPI:1962210856
Name:SERENITY COUNSELING CLINIC
Entity type:Organization
Organization Name:SERENITY COUNSELING CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH PROFESSIONAL
Authorized Official - Prefix:
Authorized Official - First Name:UBAH
Authorized Official - Middle Name:MAHAMED
Authorized Official - Last Name:HIRSI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC
Authorized Official - Phone:952-564-8226
Mailing Address - Street 1:124 HIGHWAY 13 E APT 301
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4820
Mailing Address - Country:US
Mailing Address - Phone:952-564-8226
Mailing Address - Fax:
Practice Address - Street 1:2124 DUPONT AVE S STE G2
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405-2759
Practice Address - Country:US
Practice Address - Phone:612-600-7561
Practice Address - Fax:612-314-8728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-23
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty