Youth Empowerment Support Services LLC

Primary specialty

Rehabilitation CounselorTaxonomy code 225C00000X

Legal business name

YOUTH EMPOWERMENT SUPPORT SERVICES LLC

Practice address

9085 Mitchell Rd
La Plata, MD 20646-2862

Phone

(301) 636-7010

NPI assigned

Mar 7, 2021

Organization subpart

No

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

Authorized official

Name

Tynika Cobbs

Title

Founder

Phone

(443) 359-0420

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1615075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615075200000",
    "number": "1063007433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1531",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206951531",
            "telephone_number": "443-359-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9085 MITCHELL RD",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206462862",
            "telephone_number": "301-636-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH EMPOWERMENT SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-07",
        "last_updated": "2021-03-07",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "COBBS",
        "authorized_official_first_name": "TYNIKA",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "443-359-0420"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "YouthEmpowermentSptSrv@gmail.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "9085 Mitchell Rd",
            "city": "LA Plata",
            "state": "MD",
            "country_code": "US",
            "postal_code": "206462862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patrick Carl Winters, D.C.
• Brittany Erin Wogamon, PHARMD
• Karima Woodfork, LGPC
• Zachary Yap
• Carolyn Yoos
• Fadil Ajaj Yunis, M.D.
• Melissa Zalesak, OTR/L
• Patricia Chatelain Zegowitz, PHAMD
• Jennifer L. Zeitler, CD, LCCE
• Qiyue Zhang

• Rehabilitation Counselor in La Plata, MD
• Providers in La Plata, MD by specialty
• Rehabilitation Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2021; 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.