Healthcare Provider Details

I. General information

NPI: 1851248397
Provider Name (Legal Business Name): GENESIS TAYLOR LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3681 GREEN RD STE 404
BEACHWOOD OH
44122-5716
US

IV. Provider business mailing address

1664 WINCHESTER RD
LYNDHURST OH
44124-2823
US

V. Phone/Fax

Practice location:
  • Phone: 216-342-5484
  • Fax:
Mailing address:
  • Phone: 216-773-5054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2607440
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: