1285752733 NPI number — MS. RUTH BEL GENYK MA, LMSW, LMFT

Table of content: MS. RUTH BEL GENYK MA, LMSW, LMFT (NPI 1285752733)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285752733 NPI number — MS. RUTH BEL GENYK MA, LMSW, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GENYK
Provider First Name:
RUTH
Provider Middle Name:
BEL
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MA, LMSW, LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285752733
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2301 E MICHIGAN AVE
Provider Second Line Business Mailing Address:
SUITE105
Provider Business Mailing Address City Name:
JACKSON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49202-3765
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
517-782-8313
Provider Business Mailing Address Fax Number:
517-529-9063

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2301 E MICHIGAN AVE
Provider Second Line Business Practice Location Address:
SUITE105
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49202-3700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-782-8313
Provider Business Practice Location Address Fax Number:
517-529-9063
Provider Enumeration Date:
03/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  6801058244 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: 4101005794 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: BM380014 . This is a "MCARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: COUN 0799177 . This is a "DEPT HUMAN SERVICES" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 040417 . This is a "VALUE OPTIONS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: IP2081012 . This is a "MAGELLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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