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General NPI Number Information
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NPI Number | 1972150647
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Entity Type | Organization
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Legal Business Name | GENESIS COUNSELING & CONSULTING, INC.
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Dates
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Enumeration Date | 08/19/2019
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Last Update Date | 08/18/2020
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Provider Practice Location Address
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Address Line | 6971 N FEDERAL HWY STE 206
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City | BOCA RATON
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State | FL
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Zip | 33487-1648
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Country | US
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Telephone | 561-408-1098
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Fax |
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Provider Business Mailing Address
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Address Line | 6971 N FEDERAL HWY STE 206
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City | BOCA RATON
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State | FL
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Zip | 33487-1648
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Country | US
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Telephone | 561-408-1098
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | JENNIFER BISHOP
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Credential | LMHC
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Telephone | 954-892-8603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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