Organization
SERENO CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE MIKSOVSKY (EXECUTIVE DIRECTOR)
(443) 510-0456
Entity
Organization
Contact information
Practice address
3717 DECATUR AVE STE 3, KENSINGTON, MD 20895-2148
(443) 510-0456
Mailing address
10901 CONNECTICUT AVE # 1, KENSINGTON, MD 20895-1645
(443) 510-0456
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/03/2024
Last updated
03/24/2026
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