| Serenity Counseling Services Llc | |
|
112 Office Park Dr Columbia KY 42728-1380 | |
| (270) 864-1625 | |
| (270) 864-1624 |
| Full Name | Serenity Counseling Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 112 Office Park Dr, Columbia, Kentucky |
| Authorized Official Name and Position | Crystal Stapleton (CONTRACTING DIRECTOR) |
| Authorized Official Contact | 2703801093 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Serenity Counseling Services Llc Po Box 91 Columbia KY 42728-0091 Ph: (270) 864-1625 | Serenity Counseling Services Llc 112 Office Park Dr Columbia KY 42728-1380 Ph: (270) 864-1625 |
| NPI Number | 1407304298 |
|---|---|
| Provider Enumeration Date | 09/21/2016 |
| Last Update Date | 04/09/2024 |
| Certification Date | 04/09/2024 |
| Medicare PECOS PAC ID | 0143694927 |
|---|---|
| Medicare Enrollment ID | O20230317000503 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407304298 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Teina R Thrasher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124618665 PECOS PAC ID: 5092124263 Enrollment ID: I20210429002860 |
| Provider Name | Tonya Keen Glover |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477295657 PECOS PAC ID: 8123492659 Enrollment ID: I20230323000395 |
| Provider Name | Cecelia Dawn Bunch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407258981 PECOS PAC ID: 8921472713 Enrollment ID: I20240102003431 |
| Provider Name | Jodi Martin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548358252 PECOS PAC ID: 5799136610 Enrollment ID: I20240104003425 |
| Provider Name | Ashley Hardwick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861680597 PECOS PAC ID: 9830563626 Enrollment ID: I20240124003560 |
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