Active NPI
Theresa Corinne McClurg-Genevese, LPC
- Mental Health Counselor
- Columbus, OH
National Provider Identifier
1295010320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- E.0900494
- Practice address
- 8001 Ravines Edge CT
Suite 201
Columbus, OH 43235-5423 - Phone
- (614) 896-8222
- Fax
- (614) 896-8223
- NPI assigned
- Oct 20, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | E.0900494 | OH | Primary |
Addresses
Primary practice location
8001 Ravines Edge CT
Suite 201
Columbus, OH 43235-5423
Mailing address
8001 Ravines Edge CT
Suite 201
Columbus, OH 43235-5423
Phone (614) 896-8222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E.0900494 | OH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446163200000",
"number": "1295010320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8001 RAVINES EDGE CT",
"address_2": "SUITE 201",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432355423",
"telephone_number": "614-896-8222",
"fax_number": "614-896-8223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8001 RAVINES EDGE CT",
"address_2": "SUITE 201",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432355423",
"telephone_number": "614-896-8222",
"fax_number": "614-896-8223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLURG-GENEVESE",
"first_name": "THERESA",
"middle_name": "CORINNE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-20",
"last_updated": "2015-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "E.0900494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.