Provider Demographics
NPI:1033805189
Name:SALATA, GENIVIEVE (LPC)
Entity type:Individual
Prefix:
First Name:GENIVIEVE
Middle Name:
Last Name:SALATA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 N SCOTTSDALE RD STE 2500
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7630
Mailing Address - Country:US
Mailing Address - Phone:262-999-3495
Mailing Address - Fax:
Practice Address - Street 1:6525 GREEN BAY RD STE 2
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-2967
Practice Address - Country:US
Practice Address - Phone:262-652-2406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7314-226101Y00000X
WI11614-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor