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SERENITY HOUSE PCH INC. NPI 1720396773


NPI Information

NPI: 1720396773
Provider Name: SERENITY HOUSE PCH, INC.
Classification: Marriage & Family Therapist - 106H00000X
Entity Type: Organization
Address:
210 GARDEN CIR
HINESVILLE, GA
ZIP 31313
Phone: (912) 977-4663
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SERENITY HOUSE PCH, INC. is a marriage family therapist in Hinesville, GA. The provider is a marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. SERENITY HOUSE PCH, INC. NPI is 1720396773. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

210 GARDEN CIR
HINESVILLE, GA
ZIP 31313-421
Phone: (912) 977-4663
Fax: (912) 369-6530

The provider's authorized official is Deidre Cobb Tift .
The authorized official title is President and has the following contact phone number (912) 977-4643.

The enumeration date for this NPI number is 9/23/2010 and was last updated on 9/30/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YA0400XCounselorAddiction (Substance Use Disorder)080640MICHIGANNo
2106H00000XMarriage & Family TherapistMSW002656GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1047158461AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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