| Serenity Counseling & Consulting Services Pllc | |
|
1011 Tracy Ave Duncanville TX 75137-3550 | |
| (469) 600-5056 | |
| (972) 637-7511 |
| Full Name | Serenity Counseling & Consulting Services Pllc |
|---|---|
| Speciality | Counselor |
| Location | 1011 Tracy Ave, Duncanville, Texas |
| Authorized Official Name and Position | Lynda Johnson (OWNER) |
| Authorized Official Contact | 4696005056 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Serenity Counseling & Consulting Services Pllc Po Box 380042 Duncanville TX 75138-0042 Ph: (469) 600-5056 | Serenity Counseling & Consulting Services Pllc 1011 Tracy Ave Duncanville TX 75137-3550 Ph: (469) 600-5056 |
| NPI Number | 1164909834 |
|---|---|
| Provider Enumeration Date | 07/25/2018 |
| Last Update Date | 11/15/2024 |
| Certification Date | 11/15/2024 |
| Medicare PECOS PAC ID | 5991230120 |
|---|---|
| Medicare Enrollment ID | O20241126000405 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164909834 | NPI | - | NPPES |
| 1366778151 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
| Provider Name | Lynda R Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366778151 PECOS PAC ID: 3779568829 Enrollment ID: I20241126001022 |
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