Provider Demographics
NPI:1932725983
Name:WHEELER, GENESIS A (LMHCA)
Entity type:Individual
Prefix:
First Name:GENESIS
Middle Name:A
Last Name:WHEELER
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 HEWITT AVE # 317
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3570
Mailing Address - Country:US
Mailing Address - Phone:425-231-7496
Mailing Address - Fax:
Practice Address - Street 1:307 N OLYMPIC AVE STE 234
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1322
Practice Address - Country:US
Practice Address - Phone:360-363-4234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2025-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61526722101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health