Genesis Counseling Service

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT24526 Issued in CA

Legal business name

GENESIS COUNSELING SERVICE

Practice address

1201 N China Lake Blvd
Ridgecrest, CA 93555-2660

Phone

(760) 375-6348

NPI assigned

Jan 24, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Susan Knepp Logan, MFTNPI 1942412077

Title

Satelite Director

Phone

(760) 375-6348

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Knepp Logan, MFT

  • Marriage & Family Therapist
  • Ridgecrest, CA
  • NPI 1942412077
  NPD Authorized official
• Stephanie Jefferson, PSY.D.

  • Psychologist
  • San Bernardino, CA
  • NPI 1578700050
  NPD (past)
• Tiffany Marie Lewis, LMFT

  • Marriage & Family Therapist
  • Ridgecrest, CA
  • NPI 1346727252
  NPD (past)

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201132800000",
    "number": "1417134123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E AIRPORT DR",
            "address_2": "SUITE #175",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083444",
            "telephone_number": "909-890-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N CHINA LAKE BLVD",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935552660",
            "telephone_number": "760-375-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS COUNSELING SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-24",
        "last_updated": "2008-01-24",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "KNEPP",
        "authorized_official_title_or_position": "SATELITE DIRECTOR",
        "authorized_official_telephone_number": "760-375-6348",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT24526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD CA",
            "identifier": "ZZZ66427Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Garcia, D.P.T.
• Nikki Dawn Gardepe
• Emma Nicole Gardner
• Chrisander Garrett
• General Anesthesia Services a Professional Nursing Corp
• Katherine Gerow
• Gilbert Dental Corporation
• Gilbert Dental Corporation (Palm Tree Pediatric Dentistry)
• Danielle Leanne Gilbert, DMD
• Haley Rae Gilmore, LVN

• Marriage & Family Therapist in Ridgecrest, CA
• Providers in Ridgecrest, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.