Provider Demographics
NPI:1730997768
Name:INNER SERENITY COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:INNER SERENITY COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:231-769-0526
Mailing Address - Street 1:3925 HEIGHTS RAVENNA RD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-4121
Mailing Address - Country:US
Mailing Address - Phone:231-769-0526
Mailing Address - Fax:
Practice Address - Street 1:950 TAYLOR AVE STE 100
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2281
Practice Address - Country:US
Practice Address - Phone:231-769-0526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty