Advanced Youth Counseling LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

ADVANCED YOUTH COUNSELING LLC

Practice address

3631 Beacon Dr
Beachwood, OH 44122-6008

Phone

(216) 767-9971

NPI assigned

Jul 3, 2023

Last updated

Jul 3, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Desiree Nicole SandersNPI 1396421087

Title

Owner/ Provider

Phone

(121) 676-7997

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Desiree Sanders

  • Psychiatric/Mental Health Nurse Practitioner
  • Highland Hills, OH
  • NPI 1396421087

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688342400000",
    "number": "1144907841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3631 BEACON DR",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441226008",
            "telephone_number": "216-767-9971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3631 BEACON DR",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441226008",
            "telephone_number": "216-767-9971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED YOUTH COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "DESIREE",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/ PROVIDER",
        "authorized_official_telephone_number": "121-676-7997"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Beachwood, OH
• Providers in Beachwood, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.