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Individual
MS. GENEVI J AGE
Active
Individual
MS. GENEVI J AGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSWA, LCAS-A
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-23005
NC
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
23005
NC
1041C0700X
Clinical Social Worker
Primary
P021939
NC
Other
Enumeration date
10/17/2017
Last updated
05/07/2026
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