Provider Demographics
NPI:1083720783
Name:WADSWORTH, GENENA LYNN (LPC)
Entity Type:Individual
Prefix:MS
First Name:GENENA
Middle Name:LYNN
Last Name:WADSWORTH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 CHARLOTTE ST STE 2
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1910
Mailing Address - Country:US
Mailing Address - Phone:828-803-0820
Mailing Address - Fax:
Practice Address - Street 1:188 CHARLOTTE ST STE 2
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1910
Practice Address - Country:US
Practice Address - Phone:828-803-0820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3493101YM0800X
NCLCAS-2609101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)