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GENESIS CLINCAL SERVICES NPI 1801473939


NPI Information

NPI: 1801473939
Provider Name: GENESIS CLINCAL SERVICES
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
7400 CARMEL EXECUTIVE PARK DR STE 135
CHARLOTTE, NC
ZIP 28226
Phone: (704) 464-4910
Get Directions

GENESIS CLINCAL SERVICES is a clinical psychologist in Charlotte, NC. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. GENESIS CLINCAL SERVICES NPI is 1801473939. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

7400 CARMEL EXECUTIVE PARK DR STE 135
CHARLOTTE, NC
ZIP 28226-400
Phone: (704) 464-4910
Fax: (704) 230-0856

The provider's authorized official is Chad W Kraska .
The authorized official title is Owner, Clinical Psychologist and has the following contact phone number (704) 464-4910.

The enumeration date for this NPI number is 3/25/2021 and was last updated on 3/25/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorNo
2103G00000XClinical NeuropsychologistNo
3103T00000XPsychologistNo
4103TB0200XPsychologistCognitive & BehavioralNo
5103TM1800XPsychologistIntellectual and Developmental DisabilitiesNo
6103TP0814XPsychologistPsychoanalysisNo
7103TS0200XPsychologistSchoolNo
81041C0700XSocial WorkerClinicalNo
9103TC2200XPsychologistClinical Child & AdolescentNo
10103TC1900XPsychologistCounselingNo
11103TF0000XPsychologistFamilyNo
12103TC0700XPsychologistClinicalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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