| Serenity Therapeutic Services Llc | |
|
5 Taos Trl N Corrales NM 87048-9660 | |
| (505) 670-7312 | |
| Not Available |
| Full Name | Serenity Therapeutic Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 5 Taos Trl N, Corrales, New Mexico |
| Authorized Official Name and Position | Mary Anne Little (OWNER) |
| Authorized Official Contact | 5056707312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Serenity Therapeutic Services Llc 5 Taos Trl N Corrales NM 87048-9660 Ph: (505) 670-7312 | Serenity Therapeutic Services Llc 5 Taos Trl N Corrales NM 87048-9660 Ph: (505) 670-7312 |
| NPI Number | 1750155339 |
|---|---|
| Provider Enumeration Date | 11/14/2023 |
| Last Update Date | 11/14/2023 |
| Certification Date | 11/14/2023 |
| Medicare PECOS PAC ID | 4183068935 |
|---|---|
| Medicare Enrollment ID | O20240220002232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750155339 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mary Anne Little |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386875151 PECOS PAC ID: 0244360725 Enrollment ID: I20210624001508 |
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