Antonia J Genisio, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180016629 Issued in IL

Practice address

15 Founders LN Ste 100
Jacksonville, IL 62650-3924

Phone

(217) 243-0300

Fax

(217) 245-6775

NPI assigned

Jun 17, 2022

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 IL

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Memorial Physician ServicesGroup PAC ID 9032005681, 161 clinicians

Mental Health Centers of Central IllinoisGroup PAC ID 8325940521, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: antoniagenisio@sfc.allscriptsdirect.net
• Direct secure messaging: antoniagenisio@memorial.allscriptsdirect.net

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.

• Memorial Physician Services

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1174877930

  Counselor

  Medicare reassignment Care Compare group NPD
• Mental Health Centers of Central Illinois

  dba Memorial Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Springfield, IL
  • NPI 1225008113
  Medicare reassignment Care Compare group NPD
• Family Medical Center of Chatham, LLC

  • Family Medicine Physician
  • Chatham, IL
  • NPI 1992956528
  NPD
• Memorial Health Partners

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1376034744
  NPD
• Memorial Physician Services

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1417922964
  NPD
• Memorial Physician Services

  • Rural Health Clinic/Center
  • Jacksonville, IL
  • NPI 1528741147
  NPD
• Mental Health Centers of Central Illinois

  dba Memorial Behavioral Health Counseling Associates

  • Clinical Social Worker
  • Springfield, IL
  • NPI 1750614798

  Professional

  NPD
• Springfield Clinic LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1215974415
  NPD

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1245961606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 FOUNDERS LN STE 100",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503924",
            "telephone_number": "217-243-0300",
            "fax_number": "217-245-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FOUNDERS LN STE 100",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503924",
            "telephone_number": "217-243-0300",
            "fax_number": "217-245-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENISIO",
        "first_name": "ANTONIA",
        "middle_name": "J",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-17",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180016629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.