NPIMap

Organization Active NPI

Genesis Clincal Services

  • Clinical Psychologist
  • Charlotte, NC
National Provider Identifier
1801473939
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
GENESIS CLINCAL SERVICES
Practice address
7400 Carmel Executive Park Dr Ste 135
Charlotte, NC 28226-8400
Phone
(704) 464-4910
Fax
(704) 230-0856
NPI assigned
Mar 25, 2021
Last updated
Mar 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Authorized official

Name
Dr. Chad W Kraska, PSYDNPI 1801172051
Title
Owner, Clinical Psychologist
Phone
(704) 464-4910

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 12

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Clinical Neuropsychologist 103G00000X NU
Psychologist 103T00000X NU
Cognitive & Behavioral Psychologist 103TB0200X NU
Clinical Psychologist 103TC0700X NU Primary
Counseling Psychologist 103TC1900X NU
Clinical Child & Adolescent Psychologist 103TC2200X NU
Family Psychologist 103TF0000X NU
Intellectual & Developmental Disabilities Psychologist 103TM1800X NU
Psychoanalysis Psychologist 103TP0814X NU
School Psychologist 103TS0200X NU
Clinical Social Worker 1041C0700X NU

Addresses

Primary practice location

7400 Carmel Executive Park Dr Ste 135
Charlotte, NC 28226-8400

Mailing address

7400 Carmel Executive Park Dr Ste 135
Charlotte, NC 28226-8400
Phone (704) 464-4910

National Provider Directory

National Provider Directory

Locations

7400 Carmel Executive Park Dr
Ste 135
Charlotte, NC 28226
Phone (704) 464-4910

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616630400000",
    "number": "1801473939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 CARMEL EXECUTIVE PARK DR STE 135",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282268400",
            "telephone_number": "704-464-4910",
            "fax_number": "704-230-0856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 CARMEL EXECUTIVE PARK DR STE 135",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282268400",
            "telephone_number": "704-464-4910",
            "fax_number": "704-230-0856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS CLINCAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A",
        "authorized_official_last_name": "KRASKA",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER, CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "704-464-4910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.