| Southern Serenity Counseling, LLC | |
|
1579 Cedar Lake Cir Hernando MS 38632-6955 | |
| (662) 614-0719 | |
| Not Available |
| Full Name | Southern Serenity Counseling, LLC |
|---|---|
| Speciality | Counselor |
| Location | 1579 Cedar Lake Cir, Hernando, Mississippi |
| Authorized Official Name and Position | Laurie Cooper (OWNER, COUNSELOR) |
| Authorized Official Contact | 6626140719 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Serenity Counseling, LLC 1579 Cedar Lake Cir Hernando MS 38632-6955 Ph: (662) 614-0719 | Southern Serenity Counseling, LLC 1579 Cedar Lake Cir Hernando MS 38632-6955 Ph: (662) 614-0719 |
| NPI Number | 1396562716 |
|---|---|
| Provider Enumeration Date | 09/25/2024 |
| Last Update Date | 09/25/2024 |
| Certification Date | 09/25/2024 |
| Medicare PECOS PAC ID | 4880170919 |
|---|---|
| Medicare Enrollment ID | O20260108002681 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396562716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (NU) | Primary |
| Provider Name | Laurie Bankston |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356629992 PECOS PAC ID: 5799261822 Enrollment ID: I20260204000872 |
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