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Organization
GENESIS P.A.C.E.S. LLP
Active
Organization
GENESIS P.A.C.E.S. LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLEDICIANNE DORVIL PSY.D (CO-OWNER)
(609) 393-1166
Entity
Organization
Contact information
Practice address
826 W STATE ST, SUITE A., TRENTON, NJ 08618-5350
(609) 393-1166
(609) 393-2140
Mailing address
826 W STATE ST, SUITE A., TRENTON, NJ 08618-5350
(609) 393-1166
(609) 393-2140
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
103G00000X
Clinical Neuropsychologist
—
NULL
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
NULL
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC1900X
Counseling Psychologist
—
NJ
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
NULL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
103TF0000X
Family Psychologist
—
NULL
103TF0000X
Family Psychologist
—
—
103TF0200X
Forensic Psychologist
—
NULL
103TF0200X
Forensic Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
NULL
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
NULL
103TP2701X
Group Psychotherapy Psychologist
—
—
103TS0200X
School Psychologist
—
NULL
103TS0200X
School Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
01/30/2015
Last updated
05/06/2015
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