Genesis Clinical Counseling, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

GENESIS CLINICAL COUNSELING, LLC

Practice address

2255 Dunn Ave Ste 206
Jacksonville, FL 32218-4739

Phone

(904) 201-9658

Fax

(866) 270-8565

NPI assigned

Jan 12, 2021

Last updated

Jan 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tamara Sorrye, LMHCNPI 1598061319

Title

Owner/Therapist

Phone

(904) 219-5560

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tamara N Sorrye

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1598061319
  NPD Authorized official

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610409600000",
    "number": "1649869876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 DUNN AVE STE 206",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184739",
            "telephone_number": "904-201-9658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 DUNN AVE STE 206",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184739",
            "telephone_number": "904-201-9658",
            "fax_number": "866-270-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS CLINICAL COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A",
        "authorized_official_last_name": "SORRYE",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "904-219-5560",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Genesis Health Development, Inc. (Brooks Rehab Center)
• Genesis Healthcare Corporation

• Mental Health Clinic/Center (Including Community Mental Health Center) in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.