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GENESIS PROJECT 1
NPI 1417364480
Point of Service in Charlotte, NC

Active since July 22, 2014
5108 REAGAN DR, SUITE 14, CHARLOTTE, NC 28206(704) 596-0505(704) 596-0507 Get Directions Write a Review

NPPES record last updated: July 22, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Genesis Project 1 NPPES

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

GENESIS PROJECT 1 (NPI 1417364480) is a healthcare organization registered as a point of service in Charlotte, North Carolina and active in the NPI registry since July 2014. The organization lists Trasha Black, Clinical Director, as its authorized official.

NPPES Registry Identity

NPI1417364480
Entity TypeOrganization
Primary Taxonomy305S00000X
Legal Business NameGENESIS PROJECT 1
Location Address5108 REAGAN DR, SUITE 14Charlotte, NC 28206-3103
Mailing Address5108 Reagan Dr, Suite 14Charlotte, NC 28206-3103 · (704) 596-0505 · Fax (704) 596-0507
Phone(704) 596-0505
Fax(704) 596-0507
Organization SubpartNo
Authorized OfficialTrasha BlackClinical Director · (704) 596-0505
Enumeration DateJuly 22, 2014
✔ NPI 1417364480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPoint of ServiceManaged Care Organizations
Taxonomy Code305S00000X
License✔ Licensed in NC · P009049
Definition
This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.
5108 REAGAN DR, Charlotte, NC 28206
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Other Providers at the Same Location NPPES 11

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

MR. EDWARD MURRAY IV MSW, LCSWA
Social Worker (Clinical)
5108 REAGAN DR
CHARLOTTE, NC 28206
Mecklenburg County (919) 813-0859
BRITNEY ELIZABETH HILL MA, LCMHC
Counselor (Mental Health)
5108 REAGAN DR
CHARLOTTE, NC 28206
Mecklenburg County (704) 596-0505
POSITIVE CARE SOLUTIONS INCORPORATION
Respite Care
5108 REAGAN DR, SUITE 10
CHARLOTTE, NC 28206
Mecklenburg County (704) 716-1155
JAVIETTE GRANT MS, LCMHCA, NCC
Counselor (Professional)
5108 REAGAN DR
CHARLOTTE, NC 28206
Mecklenburg County (704) 567-0790
CAROLINA OUTREACH
Clinic/Center (Mental Health (Including Community Mental Health Center))
5108 REAGAN DR
CHARLOTTE, NC 28206
Mecklenburg County (704) 332-8787
ALEXIS BRIGHTMAN L.P.A.
Psychologist
5108 REAGAN DR, SUITE 14
CHARLOTTE, NC 28206
Mecklenburg County (980) 498-6764
CHENITA FREEMAN LPC-A
Counselor (Mental Health)
5108 REAGAN DR, SUITE 14
CHARLOTTE, NC 28206
Mecklenburg County (704) 596-0505
CAROLINE WATKINS MSW, LCSWA
Social Worker (Clinical)
5108 REAGAN DR
CHARLOTTE, NC 28206
Mecklenburg County (704) 332-8787

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Genesis Project 1's NPI number?

The NPI number for Genesis Project 1 is 1417364480. It was assigned to this organization in the NPPES registry on July 22, 2014.

Where is Genesis Project 1 located?

Genesis Project 1 is located at 5108 Reagan Dr Suite 14, Charlotte, NC 28206. The listed phone number is (704) 596-0505.

What is Genesis Project 1's specialty?

The primary specialty registered for this NPI is Point of Service with taxonomy code 305S00000X.

When was this NPI record last updated?

The NPPES record for Genesis Project 1 was last updated on July 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.