Provider Demographics
NPI:1053988493
Name:SERENITY COUNSELING AND PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:SERENITY COUNSELING AND PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELTRAN-MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:PSY
Authorized Official - Phone:805-448-7469
Mailing Address - Street 1:1103 E CLARK AVE STE C
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-5145
Mailing Address - Country:US
Mailing Address - Phone:805-448-7469
Mailing Address - Fax:805-354-0806
Practice Address - Street 1:1103 E CLARK AVE STE C
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-5145
Practice Address - Country:US
Practice Address - Phone:805-448-7469
Practice Address - Fax:805-354-0806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty