Organization
GENESIS CLINCAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD W KRASKA PSYD (OWNER, CLINICAL PSYCHOLOGIST)
(704) 464-4910
Entity
Organization
Contact information
Practice address
7400 CARMEL EXECUTIVE PARK DR STE 135, CHARLOTTE, NC 28226-8400
(704) 464-4910
(704) 230-0856
Mailing address
7400 CARMEL EXECUTIVE PARK DR STE 135, CHARLOTTE, NC 28226-8400
(704) 464-4910
(704) 230-0856
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
103TS0200X
School Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
03/25/2021
Last updated
03/25/2021
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