Organization
GENESIS COUNSELING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMERON SEVERO ASHWORTH (VP OF OPERATIONS)
(926) 436-3747
Entity
Organization
Contact information
Practice address
2202 EXECUTIVE DR, SUITE C, HAMPTON, VA 23666-6604
(757) 827-7707
(757) 838-2573
Mailing address
2202 EXECUTIVE DR, SUITE C, HAMPTON, VA 23666-6604
(757) 827-7707
(757) 838-2573
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
07/01/2006
Last updated
01/29/2024
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