MEDICARE: GENESIS COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1922965979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENESIS COUNSELING LLC

Provider Business Mailing Address
First Line	:	605 NE WOODS CHAPEL RD
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64064-1900
Country	:	US
Telephone Number	:	816-272-0653
Fax Number	:

Provider Business Practice Location Address
First Line	:	605 NE WOODS CHAPEL RD
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64064-1900
Country	:	US
Telephone Number	:	816-272-0653
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	NAOMI THOMPSON
Credential	:
Telephone Number	:	816-272-0653

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	01/09/2026

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