Youth Hope Licensed Clinical Social Worker Corp

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

YOUTH HOPE LICENSED CLINICAL SOCIAL WORKER CORP

Practice address

255 N D St Ste 400
San Bernardino, CA 92401-1715

Phone

(909) 567-2808

NPI assigned

Jun 18, 2019

Organization subpart

No

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

Authorized official

Name

Cecilia De Lorenzo

Title

Secretary

Phone

(909) 567-2808

Specialties & licenses 1

Addresses

Electronic endpoints 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Geoffrey Bestman Ibeabuchi, DR. PH.D LCSW

  • Clinical Social Worker
  • San Bernardino, CA
  • NPI 1932241635
  NPD (past)

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560816000000",
    "number": "1033779343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 264",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "923690264",
            "telephone_number": "909-567-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N D ST STE 400",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011715",
            "telephone_number": "909-567-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH HOPE LICENSED CLINICAL SOCIAL WORKER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A",
        "authorized_official_last_name": "DE LORENZO",
        "authorized_official_first_name": "CECILIA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "909-567-2808"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://res.cisco.com/websafe/",
            "affiliation": "N",
            "endpointDescription": "communication",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pdf or picture",
            "address_1": "255 N D St Ste 400",
            "city": "San Bernardino",
            "state": "CA",
            "country_code": "US",
            "postal_code": "924011715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://res.cisco.com/websafe/",
            "affiliation": "N",
            "endpointDescription": "communication",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pdf or images",
            "address_1": "255 N D St Ste 400",
            "city": "San Bernardino",
            "state": "CA",
            "country_code": "US",
            "postal_code": "924011715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Your Love Story Expert
• Hany Raouf Youssef Sr.
• Helena Botros Youssef, MPP
• Susie Ann Youssef, LCSW
• Youth Hope Inc.
• Youths' Hope Licensed Clinical Social Worker Inc
• Sydney Yu, DDS
• Sanghyun Daniel Yun
• Kar-Wai Yung, M.D.
• Braden Yzaguirre

• Clinical Social Worker in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.