| Serenity Healing Center Counseling & Consultation Services, Llc | |
|
26677 W 12 Mile Rd Southfield MI 48034-1514 | |
| (248) 259-5733 | |
| (855) 287-5729 |
| Full Name | Serenity Healing Center Counseling & Consultation Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 26677 W 12 Mile Rd, Southfield, Michigan |
| Authorized Official Name and Position | Pandora Brown (OWNER) |
| Authorized Official Contact | 2482595733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Serenity Healing Center Counseling & Consultation Services, Llc 26677 W 12 Mile Rd Southfield MI 48034-1514 Ph: (248) 259-5733 | Serenity Healing Center Counseling & Consultation Services, Llc 26677 W 12 Mile Rd Southfield MI 48034-1514 Ph: (248) 259-5733 |
| NPI Number | 1063985786 |
|---|---|
| Provider Enumeration Date | 01/04/2019 |
| Last Update Date | 08/14/2023 |
| Certification Date | 08/14/2023 |
| Medicare PECOS PAC ID | 2163768748 |
|---|---|
| Medicare Enrollment ID | O20190118001793 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063985786 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jedonna L Young |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215195805 PECOS PAC ID: 8224199609 Enrollment ID: I20081203000630 |
| Provider Name | Pandora L Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669915104 PECOS PAC ID: 9032491162 Enrollment ID: I20170124002720 |
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