Organization
GENESIS THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE E FAIRFIELD D.MIN., LCPC (EXECUTIVE DIRECTOR)
(708) 535-7320
Entity
Organization
Contact information
Practice address
6006 W. 159TH STREET, BLDG. C, OAK FOREST, IL 60452
(708) 535-7320
(708) 535-7571
Mailing address
6006 W. 159TH STREET, BLDG. C, OAK FOREST, IL 60452
(708) 535-7320
(708) 535-7571
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/28/2006
Last updated
12/05/2024
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