NPIMap

Organization Active NPI

Genesis Counseling Center, Inc.

  • Psychiatry Physician
  • Chagrin Falls, OH
National Provider Identifier
1801088604
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35.063299 Issued in OH
Legal business name
GENESIS COUNSELING CENTER, INC.
Practice address
17747 Chillicothe Rd Ste 105
Chagrin Falls, OH 44023-4765
Phone
(440) 543-8880
NPI assigned
Aug 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Authorized official

Name
Dr. William FikterNPI 1366468720
Title
MD
Phone
(440) 543-8880

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 35.063299 OH Primary

Addresses

Primary practice location

17747 Chillicothe Rd Ste 105
Chagrin Falls, OH 44023-4765

Mailing address

17747 Chillicothe Rd Ste 105
Chagrin Falls, OH 44023-4765
Phone (440) 543-8880

Other identifiers 4

IdentifierTypeStateIssuer
000000136790OtherANTHEM BLUE CROSS
0147004MedicaidOH
191762OtherVALUE OPTIONS
5781747OtherAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100326000609 OH Part B Supplier - Clinic/Group Practice 6901995158 Receives reassigned benefits from 3 practitioners
Practice locations: Chagrin Falls, OH

National Provider Directory

National Provider Directory

Locations

17747 Chillicothe Rd
Ste 202
Chagrin Falls, OH 44023
Phone (440) 543-8880

17747 Chillicothe Rd
Ste 105
Chagrin Falls, OH 44023
Phone (440) 453-8880

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733443200000",
    "number": "1801088604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17747 CHILLICOTHE RD STE 105",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440234765",
            "telephone_number": "440-543-8880",
            "fax_number": "440-543-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17747 CHILLICOTHE RD STE 105",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440234765",
            "telephone_number": "440-543-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A",
        "authorized_official_last_name": "FIKTER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "440-543-8880",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.063299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000136790",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0147004",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "191762",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5781747",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chagrin Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.