BLACK SERENE, PLLC
NPI 1184472573
Counselor - Professional in Fayetteville, NC
NPI Status: Active since May 09, 2024
Contact Information
3350 FOOTBRIDGE LN
STE 124 #524
FAYETTEVILLE, NC
ZIP 28306
Phone: (404) 649-5274
- Organization
- Counselor
- Professional
About BLACK SERENE, PLLC
This page provides the complete NPI Profile along with additional information for Black Serene, Pllc, a provider established in Fayetteville, North Carolina operating as a Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1184472573 assigned on May 2024. The practitioner's primary taxonomy code is 101YP2500X. The provider is registered as an organization and their NPI record was last updated May 2026. Black Serene, Pllc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Dazzmen Nikole Davis Lcmhc, Lpc (Practice Owner/licensed Counselor)
- NPI
- 1184472573
- Provider Name
- BLACK SERENE, PLLC
- Entity Type
- Organization
- Location Address
- 3350 FOOTBRIDGE LN STE 124 #524 FAYETTEVILLE, NC 28306
- Location Phone
- (404) 649-5274
- Mailing Address
- 3350 FOOTBRIDGE LN STE 124 #524 FAYETTEVILLE, NC 28306
- Mailing Phone
- (980) 990-2642
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-09-2024
- Last Update Date
- 05-06-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Professional
- Taxonomy Code
- 101YP2500X
- Type
- Behavioral Health & Social Service Providers
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YM0800X | Behavioral Health & Social Service Providers | Counselor |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1184472573, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
FAYETTEVILLE, NC 28306
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1184472573, enumerated as an "organization" on May 09, 2024.
The provider is located at 3350 FOOTBRIDGE LN STE 124 #524 FAYETTEVILLE, NC 28306 and the phone number is (404) 649-5274.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
