Kristen Ann Genzano

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C4447 Issued in OR

Practice address

8885 SW Canyon Rd Ste 215
Portland, OR 97225-3429

Phone

(971) 712-6260

NPI assigned

Jun 22, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 4, 2024 through Apr 4, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Kristen Genzano Therapy LLC

  • Counselor
  • Portland, OR
  • NPI 1831540095
  NPD Authorized official

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1679924583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5126 NE 32ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972116940",
            "telephone_number": "480-250-5932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8885 SW CANYON RD STE 215",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972253429",
            "telephone_number": "971-712-6260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5300 SE Foster Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972062938",
            "country_code": "US",
            "telephone_number": "480-250-5932",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "510 SW 3rd Avenue",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972042635",
            "country_code": "US",
            "telephone_number": "480-250-5932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENZANO",
        "first_name": "KRISTEN",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.011112",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60665316",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C4447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabitha Gentry, LMT
• Elizabeth Christiane Gentzkow, LPC
• Genuine Home Care LLC
• Colleen Genuine, LMT
• Lydia Genz
• Gary Lee Genzer, DMD
• Geoff Geness
• Geoff Geness
• Geoffrey Buncke MD PC
• George Cluen

• Professional Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.

Verify at the official NPI Registry.