Provider Demographics
NPI:1053719518
Name:GENESIS COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:GENESIS COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LAC, CACII, MAC
Authorized Official - Phone:864-515-6440
Mailing Address - Street 1:364 S PINE ST STE A110
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-2654
Mailing Address - Country:US
Mailing Address - Phone:864-515-6440
Mailing Address - Fax:864-308-2442
Practice Address - Street 1:364 S PINE ST STE A110
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-2654
Practice Address - Country:US
Practice Address - Phone:864-515-6440
Practice Address - Fax:864-308-2442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-16
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder