Organization
GENESIS COUNSELING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CAMERON ASHWORTH (VP OF OPERATIONS)
(757) 827-7707
Entity
Organization
Contact information
Practice address
2202 EXECUTIVE DR, SUITE C, HAMPTON, VA 23666-6604
(757) 827-7707
Mailing address
2202 EXECUTIVE DR, SUITE C, HAMPTON, VA 23666-6604
(757) 827-7707
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
04/07/2011
Last updated
01/29/2024
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