Provider Demographics
NPI:1053159608
Name:SWEET SERENITY MENTAL HEALTH LLC
Entity type:Organization
Organization Name:SWEET SERENITY MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER; THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CORRIE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP, LPC
Authorized Official - Phone:501-259-4682
Mailing Address - Street 1:17232 PALISADES DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68136-4196
Mailing Address - Country:US
Mailing Address - Phone:501-259-4682
Mailing Address - Fax:
Practice Address - Street 1:8790 F ST STE 109
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1522
Practice Address - Country:US
Practice Address - Phone:501-259-4682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-17
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty