Provider Demographics
NPI:1164908547
Name:SERENDIPITY COUNSELING SERVICES, INC
Entity type:Organization
Organization Name:SERENDIPITY COUNSELING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:DICOSTANZO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CADC, MISA I
Authorized Official - Phone:630-866-7393
Mailing Address - Street 1:29W170 BUTTERFIELD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-2808
Mailing Address - Country:US
Mailing Address - Phone:331-305-4464
Mailing Address - Fax:630-381-8556
Practice Address - Street 1:29W170 BUTTERFIELD RD STE 101
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-2808
Practice Address - Country:US
Practice Address - Phone:331-305-4464
Practice Address - Fax:630-381-8556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-18
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.018138261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1487072070OtherNPPES