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General NPI Number Information
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NPI Number | 1891275467
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Entity Type | Organization
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Legal Business Name | GENESIS COUNSELING CENTER, INC
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Dates
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Enumeration Date | 08/14/2018
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Last Update Date | 08/14/2018
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Provider Practice Location Address
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Address Line | 1000 ATLANTIC AVENUE 5TH FLOOR
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City | CAMDEN
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State | NJ
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Zip | 08104
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Country | US
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Telephone | 856-964-3955
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Fax | 856-964-9332
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Provider Business Mailing Address
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Address Line | 566 HADDON AVENUE
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City | COLLINGSWOOD
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State | NJ
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Zip | 08108
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Country | US
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Telephone | 856-858-9314
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Fax | 856-858-5672
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Authorized Official
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Title or Position | VICE PRESIDENT OF OPERATIONS
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Name | KAREN COLE
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Credential |
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Telephone | 856-858-9314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | NJ
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