Provider Demographics
NPI:1548916323
Name:PEACE N TRANQUILITY COUNSELING SERVICE
Entity type:Organization
Organization Name:PEACE N TRANQUILITY COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNTA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRENT
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:513-608-3856
Mailing Address - Street 1:6686 FAYETTA DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-0536
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8080 BECKETT CENTER DR STE 223
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-5037
Practice Address - Country:US
Practice Address - Phone:513-608-3856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0008428OtherLICENSE