# GENYSIS RESTORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659764686
- **Authorized official:** ETHEL MIDDLEBROOKS DEGREE (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (216) 299-8789

## Contact information

- **Practice address:** 324 EUCLID SQUARE MALL, EUCLID, OH 44132-2808
- **Practice address phone:** (216) 299-8789
- **Mailing address:** 324 EUCLID SQUARE MALL, EUCLID, OH 44132-2808
- **Mailing address phone:** (216) 299-8789

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 0000000 | OH | — |
| 101YM0800X | Mental Health Counselor | OH1037248 | OH | Yes |
| 101YP1600X | Pastoral Counselor | 0000000 | OH | — |
| 101YS0200X | School Counselor | 0000000 | OH | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | 0000000 | OH | — |
| 103TM1800X | Intellectual & Developmental Disabilities Psychologist | 000000 | OH | — |
| 103TP2701X | Group Psychotherapy Psychologist | 000000 | OH | — |
| 103TR0400X | Rehabilitation Psychologist | 000000 | OH | — |
| 1041C0700X | Clinical Social Worker | 000000 | OH | — |
| 106H00000X | Marriage & Family Therapist | 000000 | OH | — |

## Other

- **Enumeration date:** 03/16/2015
- **Last updated:** 03/16/2015