Genevieve Stafford, LCMHCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A15750 Issued in NC

Practice address

1180 N Main St
Kernersville, NC 27284-9856

Phone

(336) 283-3830

NPI assigned

Aug 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kernersville Counseling Center PLLC

  • Community/Behavioral Health Agency
  • Kernersville, NC
  • NPI 1669836136
  Medicare reassignment NPD

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1245840099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 N ELM ST APT 3N",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552864",
            "telephone_number": "845-522-2647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 N MAIN ST",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272849856",
            "telephone_number": "336-283-3830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Northgate Park Dr",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271063486",
            "country_code": "US",
            "telephone_number": "888-446-7301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "GENEVIEVE",
        "credential": "LCMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A15750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mandy Marie Sperle, FNP-C
• Kristen Anne Spoon, PHARMD
• Rachel Sprague, M.ED, LCMHC
• Jerry David Spriggs Jr., PSY.D.
• Springwell Network, Inc.
• Gregory Benjamin Stahr, DMD
• Star Care Network Inc
• Star Care Network Inc
• Star Care Network Inc
• Star Care Network Inc

• Mental Health Counselor in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.