Provider Demographics
NPI:1437958865
Name:SERENITY SPRINGS COUNSELING LLC
Entity type:Organization
Organization Name:SERENITY SPRINGS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTENESN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:385-550-7531
Mailing Address - Street 1:724 FRONT ST STE 512
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:WY
Mailing Address - Zip Code:82930-3567
Mailing Address - Country:US
Mailing Address - Phone:307-444-2308
Mailing Address - Fax:
Practice Address - Street 1:520 W 2200 N
Practice Address - Street 2:
Practice Address - City:WEST BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84087-1017
Practice Address - Country:US
Practice Address - Phone:385-550-7531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health