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General NPI Number Information
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NPI Number | 1245928779
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Entity Type | Organization
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Legal Business Name | GENESIS COUNSELING & CONSULTING SERVICES LLC
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 360 SARALAND BLVD N
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City | SARALAND
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State | AL
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Zip | 36571-2110
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Country | US
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Telephone | 251-320-3363
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Fax |
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Provider Business Mailing Address
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Address Line | 360 SARALAND BLVD N
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City | SARALAND
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State | AL
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Zip | 36571-2110
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Country | US
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Telephone | 251-320-3363
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | CHERISH BRANNON
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Credential |
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Telephone | 251-320-3363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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