Healthcare Provider Details

I. General information

NPI: 1740570043
Provider Name (Legal Business Name): GENEVIEVE ANN BARTUSKI PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2011
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 N PARK ST STE A
MARION VA
24354-2639
US

IV. Provider business mailing address

113 N PARK ST STE A
MARION VA
24354-2639
US

V. Phone/Fax

Practice location:
  • Phone: 276-246-2912
  • Fax:
Mailing address:
  • Phone: 276-246-2912
  • Fax: 276-800-8673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number40522
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number40522
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number40522
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number0810009332
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810009332
License Number StateVA
# 7
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number0810009332
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: