Provider Demographics
NPI:1487001194
Name:GENESIS COUNSELING AND CONSULTING, LLC
Entity Type:Organization
Organization Name:GENESIS COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:VOS
Authorized Official - Last Name:LUEKING
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC-MH, NCC, LAC
Authorized Official - Phone:605-759-0267
Mailing Address - Street 1:PO BOX 656
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57101-0656
Mailing Address - Country:US
Mailing Address - Phone:605-759-0267
Mailing Address - Fax:
Practice Address - Street 1:707 E 41ST ST
Practice Address - Street 2:200
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6054
Practice Address - Country:US
Practice Address - Phone:605-759-0267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD12031504101YA0400X
SDLPCMH2261101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty