| Serenity Space Counseling, Pllc | |
|
1122 Sam Newell Rd Ste 110 Matthews NC 28105-5016 | |
| (704) 931-8371 | |
| (877) 259-6224 |
| Full Name | Serenity Space Counseling, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1122 Sam Newell Rd Ste 110, Matthews, North Carolina |
| Authorized Official Name and Position | Lisa K Paden (OWNER/THERAPIST) |
| Authorized Official Contact | 7049318371 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Serenity Space Counseling, Pllc 1122 Sam Newell Rd Ste 110 Matthews NC 28105-5016 Ph: (704) 931-8371 | Serenity Space Counseling, Pllc 1122 Sam Newell Rd Ste 110 Matthews NC 28105-5016 Ph: (704) 931-8371 |
| NPI Number | 1851773360 |
|---|---|
| Provider Enumeration Date | 06/20/2015 |
| Last Update Date | 08/31/2025 |
| Certification Date | 08/31/2025 |
| Medicare PECOS PAC ID | 8022306042 |
|---|---|
| Medicare Enrollment ID | O20161006001974 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851773360 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C009546 (North Carolina) | Primary |
| Provider Name | Stefanie I Goldman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669804423 PECOS PAC ID: 1759679772 Enrollment ID: I20161006002035 |
| Provider Name | Kimberleigh Hagar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205254760 PECOS PAC ID: 7911202882 Enrollment ID: I20191021000483 |
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