ROSALIE GENOVA LCPC CCS NPI 1134837222

NPI Information

  • NPI: 1134837222
  • Provider Name: ROSALIE GENOVA, LCPC, CCS
  • Classification: Clinic/Center - 261QM0850X
  • Specialization: Adult Mental Health
  • Entity Type: Organization
  • Address: 1250 FOREST AVE
    PORTLAND WELLNESS COOPERATIVE, UNIT 14, SUITE 7
    PORTLAND, ME
    ZIP 04103
  • Phone: (207) 200-3789

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NPI Details

ROSALIE GENOVA, LCPC, CCS is an adult mental health clinic center in Portland, ME. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. ROSALIE GENOVA, LCPC, CCS NPI is 1134837222. The provider is registered as an organization entity type.

The provider's business location address is:

1250 FOREST AVE
PORTLAND WELLNESS COOPERATIVE, UNIT 14, SUITE 7
PORTLAND, ME
ZIP 04103
Phone: (207) 200-3789

The provider's authorized official is Rosalie Genova .
The authorized official title is Owner and has the following contact phone number (207) 200-3789.

The enumeration date for this NPI number is 11/8/2022 and was last updated on 11/8/2022.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthNo
2261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
3261QM0850XClinic/CenterAdult Mental HealthYes

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: 3/30/2025

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