MS. GENEVI J AGE LCSWA, LCAS-A - NPI 1053822130

Q: What is Genevi Age's NPI number?

The NPI number for Genevi Age is 1053822130. It was assigned to this individual provider in the NPPES registry on October 17, 2017.

Q: What is Genevi Age's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Genevi Age was last updated on May 7, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

On this page

About Ms. Genevi J Age Lcswa, Lcas-a NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. GENEVI J AGE LCSWA, LCAS-A (NPI 1053822130) is an individual clinical provider in Raleigh, North Carolina, licensed in North Carolina (P021939) and active in the NPI registry since October 2017.

NPPES Registry Identity

NPI1053822130

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMS. GENEVI J AGECredential: LCSWA, LCAS-A

Location Address4805 GREEN RD STE 103Raleigh, NC 27616-2848

Mailing Address1060 Paddington Ave, Northeast, Suite 103Leland, NC 28451 · (919) 872-6220 · Fax (919) 872-6223

Phone(919) 872-6220

Fax(919) 872-6223

Sole ProprietorNo

Enumeration DateOctober 17, 2017

Last NPPES UpdateMay 7, 20262 updates tracked since enumeration

NPPES CertifiedMay 7, 2026

✔ NPI 1053822130 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in NC · P021939

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License LCAS-23005 (NC)

4805 GREEN RD STE 103, Raleigh, NC 27616

Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALISA GAIL GANT-GIBBS LCSWA

Social Worker (Clinical)