Provider Demographics
NPI:1346984952
Name:GENUINE CONNECTIONS THERAPY LLC
Entity Type:Organization
Organization Name:GENUINE CONNECTIONS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARABALE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:541-933-9142
Mailing Address - Street 1:461 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-4937
Mailing Address - Country:US
Mailing Address - Phone:541-933-9142
Mailing Address - Fax:
Practice Address - Street 1:175 W B ST STE B1
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-4515
Practice Address - Country:US
Practice Address - Phone:541-933-9142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty