# SERENITY PSYCHIATRIC OUTPATIENT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881973642
- **Authorized official:** KRISTI STOGNER LCSW (PRESIDENT)
- **Authorized official phone:** (601) 684-8284

## Contact information

- **Practice address:** 300 RAWLS DR STE 900, MCCOMB, MS 39648-2864
- **Practice address phone:** (601) 684-8284
- **Practice address fax:** (601) 684-8199
- **Mailing address:** 300 RAWLS DR STE 900, MCCOMB, MS 39648-2864
- **Mailing address phone:** (601) 684-8284
- **Mailing address fax:** (601) 684-8199

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 08/11/2011
- **Last updated:** 06/20/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 05503121 | — | MS |