| Serenity Therapeutic Consultation Llc | |
|
17 12th Ave S Ste 201 Nampa ID 83651-3952 | |
| (208) 960-6916 | |
| (208) 965-2052 |
| Full Name | Serenity Therapeutic Consultation Llc |
|---|---|
| Speciality | Counselor |
| Location | 17 12th Ave S Ste 201, Nampa, Idaho |
| Authorized Official Name and Position | Margaret Jane Hedelius (LCPC) |
| Authorized Official Contact | 2085707234 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Serenity Therapeutic Consultation Llc 17 12th Ave S Ste 201 Nampa ID 83651-3952 Ph: (208) 960-6916 | Serenity Therapeutic Consultation Llc 17 12th Ave S Ste 201 Nampa ID 83651-3952 Ph: (208) 960-6916 |
| NPI Number | 1770337818 |
|---|---|
| Provider Enumeration Date | 04/15/2024 |
| Last Update Date | 04/15/2024 |
| Certification Date | 04/15/2024 |
| Medicare PECOS PAC ID | 8628418902 |
|---|---|
| Medicare Enrollment ID | O20240503000835 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770337818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Margaret Jane Hedelius |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770052821 PECOS PAC ID: 9436594264 Enrollment ID: I20240503001233 |
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