Provider Demographics
NPI:1790426476
Name:ALISHA GENETIN COUNSELING
Entity Type:Organization
Organization Name:ALISHA GENETIN COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GENETIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:937-631-8104
Mailing Address - Street 1:10038 NE 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3502
Mailing Address - Country:US
Mailing Address - Phone:937-631-8104
Mailing Address - Fax:
Practice Address - Street 1:10038 NE 15TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3502
Practice Address - Country:US
Practice Address - Phone:937-631-8104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)