Provider Demographics
NPI:1972321370
Name:SERENE MINDS THERAPY AND WELLNESS
Entity type:Organization
Organization Name:SERENE MINDS THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGGETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-621-8135
Mailing Address - Street 1:20015 S LAGRANGE RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-3104
Mailing Address - Country:US
Mailing Address - Phone:773-340-9622
Mailing Address - Fax:
Practice Address - Street 1:4834 157TH ST
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-3510
Practice Address - Country:US
Practice Address - Phone:773-340-9622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty