NPIMap

Organization Active NPI

National Youth Advocate Program, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • South Bend, IN
National Provider Identifier
1003374422
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
NATIONAL YOUTH ADVOCATE PROGRAM, INC
Practice address
3631 Edison Rd
South Bend, IN 46615-3715
Phone
(800) 270-3756
Fax
(219) 293-8604
NPI assigned
Mar 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michelle Yvonne Lizardi, CPC
Title
Medicaid Billing Specialist II
Phone
(614) 227-9430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3631 Edison Rd
South Bend, IN 46615-3715

Mailing address

1801 Watermark Dr Ste 200
Columbus, OH 43215-7088
Phone (888) 202-2965

National Provider Directory

National Provider Directory
Tax ID family
National Youth Advocate Program52 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 9

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551744000000",
    "number": "1003374422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 WATERMARK DR STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432157088",
            "telephone_number": "888-202-2965",
            "fax_number": "614-487-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3631 EDISON RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466153715",
            "telephone_number": "800-270-3756",
            "fax_number": "219-293-8604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL YOUTH ADVOCATE PROGRAM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-05",
        "last_updated": "2019-03-05",
        "status": "A",
        "authorized_official_last_name": "LIZARDI",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "YVONNE",
        "authorized_official_title_or_position": "MEDICAID BILLING SPECIALIST II",
        "authorized_official_telephone_number": "614-227-9430",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.