Organization
BLACK SERENE, PLLC
Active
Organization
BLACK SERENE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAZZMEN NIKOLE DAVIS LCMHC, LPC (PRACTICE OWNER/LICENSED COUNSELOR)
(404) 649-5274
Entity
Organization
Contact information
Practice address
3350 FOOTBRIDGE LN, STE 124 #524, FAYETTEVILLE, NC 28306-9695
(404) 649-5274
Mailing address
3350 FOOTBRIDGE LN STE 124, #524, FAYETTEVILLE, NC 28306-9695
(980) 990-2642
(404) 726-4881
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
251B00000X
Case Management Agency
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Enumeration date
05/09/2024
Last updated
05/06/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up