NPIMap

Organization Active NPI

Youth Service Bureau of Illinios Valley

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Princeton, IL
National Provider Identifier
1083462352
Registry record updated May 10, 2024
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
YOUTH SERVICE BUREAU OF ILLINIOS VALLEY
Practice address
20 W Century Dr
Princeton, IL 61356-9051
Phone
(815) 433-3953
Fax
(815) 433-3980
NPI assigned
May 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Authorized official

Name
Jennifer Bauer, LCSW
Title
Treatment Director
Phone
(815) 433-3953

Specialties & licenses 1

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

Addresses

Primary practice location

20 W Century Dr
Princeton, IL 61356-9051

Mailing address

424 W Madison St
Ottawa, IL 61350-2833
Phone (815) 431-3051

National Provider Directory

National Provider Directory
Tax ID family
Youth Service Bureau of Illinois Valley8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

20 W Century Dr
Princeton, IL 61356
Phone (815) 433-3953

NPI Registry JSON

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1083462352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 W MADISON ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613502833",
            "telephone_number": "815-431-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W CENTURY DR",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613569051",
            "telephone_number": "815-433-3953",
            "fax_number": "815-433-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH SERVICE BUREAU OF ILLINIOS VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "BAUER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "TREATMENT DIRECTOR",
        "authorized_official_telephone_number": "815-433-3953",
        "authorized_official_credential": "LCSW"
    },
    "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 Princeton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.