Gena Pittman Phillips, LPC, LCAS, CCS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5334 Issued in NC

Practice address

1662 Booker Dairy Rd
Smithfield, NC 27577-9405

Phone

(919) 938-0046

Fax

(919) 938-0056

NPI assigned

Dec 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: genaphillips@tdh.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.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Professional

  NPD
• Carolina Counseling & Consultation Services

  • Mental Health Counselor
  • Smithfield, NC
  • NPI 1902859333
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285200000000",
    "number": "1417019795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 ANDERBY DR",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275277011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1662 BOOKER DAIRY RD",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275779405",
            "telephone_number": "919-938-0046",
            "fax_number": "919-938-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "GENA",
        "middle_name": "PITTMAN",
        "name_prefix": "Mrs.",
        "credential": "LPC, LCAS, CCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2010-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "887",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "5334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "5334",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103397",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCAS",
            "identifier": "887",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Efrain Perez-Rivera, M.D.
• Frunze Petrosyan, M.D.
• Elizabeth Ivy Pfeiffer, M.S.,CCC-SLP
• Ann Thimsen Pflugrath, M.D.
• Huynh Nhu Pham, PHARM. D
• Julia Phillips
• Anne Elizabeth Phoenix, MS, CCC-SLP
• Mary Elizabeth Stallings Pippin, MS, LPA, BCBA
• Jesse Calvin Pittard, M.D.
• Playtime 4 Kidz Therapy, LLC

• Professional Counselor in Smithfield, NC
• Providers in Smithfield, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; 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.