NPIMap

Organization Active NPI

Genesee Valley Psychology, PLLC

  • Adult Mental Health Clinic/Center
  • Rochester, NY
National Provider Identifier
1679114169
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
GENESEE VALLEY PSYCHOLOGY, PLLC
Practice address
200 White Spruce Blvd
Suite 220
Rochester, NY 14623
Phone
(585) 201-8017
Fax
(585) 495-2384
NPI assigned
Oct 5, 2019
Last updated
Aug 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Authorized official

Name
Dr. Lauren P Wadsworth, PHDNPI 1356861884
Title
Director/Owner of Genesse Valley PS
Phone
(585) 270-1679

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Adult Mental Health Clinic/Center 261QM0850X NU Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU

Addresses

Primary practice location

200 White Spruce Blvd
Suite 220
Rochester, NY 14623

Mailing address

200 White Spruce Blvd
Suite 220
Rochester, NY 14623
Phone (585) 201-8017

Other identifiers 1

IdentifierTypeStateIssuer
06508112MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200618003102 NY Part B Supplier - Clinic/Group Practice 0648692780 Receives reassigned benefits from 11 practitioners
Practice locations: Rochester, NY

National Provider Directory

National Provider Directory

Locations

200 White Spruce Blvd
Ste 200
Rochester, NY 14623
Phone (585) 270-1679

200 White Spruce Blvd
Ste 220
Rochester, NY 14623
Phone (585) 270-1679

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1570233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659657600000",
    "number": "1679114169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WHITE SPRUCE BLVD",
            "address_2": "SUITE 220",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14623",
            "telephone_number": "585-201-8017",
            "fax_number": "585-495-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WHITE SPRUCE BLVD",
            "address_2": "SUITE 220",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14623",
            "telephone_number": "585-201-8017",
            "fax_number": "585-495-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESEE VALLEY PSYCHOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "WADSWORTH",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DIRECTOR/OWNER OF GENESSE VALLEY PS",
        "authorized_official_telephone_number": "585-270-1679",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06508112",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.