Organization
GENESIS MENTAL HEALTH INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE SPEIDEL LPC (PRESIDENT)
(540) 300-6150
Entity
Organization
Contact information
Practice address
32 WATERLOO ST STE 103, WARRENTON, VA 20186-3219
(540) 300-6150
Mailing address
32 WATERLOO ST STE 103, WARRENTON, VA 20186-3219
(540) 300-6150
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083993125
NPI
—
Enumeration date
11/18/2020
Last updated
09/23/2021
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