Active NPI
Genesis House, Inc
- Clinic/Center
- Williamsport, PA
National Provider Identifier
1801995832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- GENESIS HOUSE, INC
- Practice address
- 800 West 4TH Street
Steg-01
Williamsport, PA 17701-7201 - Phone
- (570) 322-0520
- Fax
- (570) 326-9674
- NPI assigned
- Sep 22, 2006
- Last updated
- Oct 27, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Shakeena Bernique Lee, MSW, LSW, ACSW, CAAD
- Title
- Executive Director
- Phone
- (570) 322-0520
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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | |||
| Clinic/Center | 261Q00000X | Primary | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Adult Mental Health Clinic/Center | 261QM0850X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 417015 | PA | |
| Community/Behavioral Health Agency | 251S00000X |
Addresses
Primary practice location
800 West 4TH Street
Steg-01
Williamsport, PA 17701-7201
Mailing address
800 West 4TH Street
Steg-01
Williamsport, PA 17701-7201
Phone (570) 322-0520
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 999036 | Other | PA | BC NE PA |
| 1007283800008 | Medicaid | PA | |
| 807234 | Other | PA | FPH NE PA |
National Provider Directory
National Provider Directory- Tax ID family
- Genesis House Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Public Health or Welfare Agency
- Bloomsburg, PA
- NPI 1518124783
-
- Clinic/Center
- Harrisburg, PA
- NPI 1609976661
Locations
800 W 4th St
Ste 1
Williamsport, PA 17701
Phone (570) 322-0520
800 W 4th St
Ste G01
Williamsport, PA 17701
Phone (570) 322-0520
Practitioners & affiliated clinicians
Practitioners 4
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.
-
- Mental Health Counselor
- Williamsport, PA
- NPI 1861118010
Addiction (Substance Use Disorder)
-
- Addiction (Substance Use Disorder) Counselor
- Danville, PA
- NPI 1811342512
-
- Obstetrics & Gynecology Physician
- Pottsville, PA
- NPI 1093713166
-
- Psychiatric/Mental Health Nurse Practitioner
- Brooklyn, NY
- NPI 1225497894
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1761523200000",
"number": "1801995832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 WEST 4TH STREET",
"address_2": "STEG-01",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177017201",
"telephone_number": "570-322-0520",
"fax_number": "570-326-9674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 WEST 4TH STREET",
"address_2": "STEG-01",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177017201",
"telephone_number": "570-322-0520",
"fax_number": "570-326-9674"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GENESIS HOUSE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-22",
"last_updated": "2025-10-27",
"certification_date": "2025-10-27",
"status": "A",
"authorized_official_last_name": "LEE",
"authorized_official_first_name": "SHAKEENA",
"authorized_official_middle_name": "BERNIQUE",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "570-322-0520",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "MSW, LSW, ACSW, CAAD"
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": null,
"license": null,
"primary": false
},
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "PA",
"license": "417015",
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC NE PA",
"identifier": "999036",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007283800008",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FPH NE PA",
"identifier": "807234",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williamsport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.