NPIMap

Organization Active NPI

Linda S Geronilla PHD Inc

  • Counseling Psychologist
  • Charleston, WV
National Provider Identifier
1043263635
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
385 Issued in WV
Legal business name
LINDA S GERONILLA PHD INC
Practice address
92 Cook Dr
Charleston, WV 25314-1003
Phone
(304) 342-2260
Fax
(304) 344-4522
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Linda S. Geronilla, PH.D.
Title
President
Phone
(304) 342-2260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X 385 WV Primary

Addresses

Primary practice location

92 Cook Dr
Charleston, WV 25314-1003

Mailing address

92 Cook Dr
Charleston, WV 25314-1003
Phone (304) 342-2260

Other identifiers 1

IdentifierTypeStateIssuer
0163217000MedicaidWV

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1043263635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 COOK DR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253141003",
            "telephone_number": "304-342-2260",
            "fax_number": "304-344-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 COOK DR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253141003",
            "telephone_number": "304-342-2260",
            "fax_number": "304-344-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDA S GERONILLA PHD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "GERONILLA",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-342-2260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "WV",
            "license": "385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0163217000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.