Provider Demographics
NPI:1427229608
Name:GENESIS COUNSELING
Entity Type:Organization
Organization Name:GENESIS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CAC III
Authorized Official - Phone:303-919-5400
Mailing Address - Street 1:415 4TH AVE
Mailing Address - Street 2:PO BOX 494
Mailing Address - City:HUGO
Mailing Address - State:CO
Mailing Address - Zip Code:80821
Mailing Address - Country:US
Mailing Address - Phone:719-743-2459
Mailing Address - Fax:
Practice Address - Street 1:415 4TH AVE
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:CO
Practice Address - Zip Code:80821
Practice Address - Country:US
Practice Address - Phone:719-743-2459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty