Provider Demographics
NPI:1962962332
Name:S.E.R.E.N.E. COUNSELING CENTER
Entity type:Organization
Organization Name:S.E.R.E.N.E. COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESDIENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LECHANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDGER
Authorized Official - Suffix:
Authorized Official - Credentials:LICDC
Authorized Official - Phone:216-254-7976
Mailing Address - Street 1:13803 ROSALIE DR
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-1933
Mailing Address - Country:US
Mailing Address - Phone:216-254-7976
Mailing Address - Fax:
Practice Address - Street 1:17325 EUCLID AVE STE 2176
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-1247
Practice Address - Country:US
Practice Address - Phone:216-254-7976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1134672009OtherNPI
OHPENDINGOtherALL NUMBERS ARE PENDING