NPIMap

Organization Active NPI

Guilford Youth Initiative, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • High Point, NC
National Provider Identifier
1275699985
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
MHL-041-737 Issued in NC
Legal business name
GUILFORD YOUTH INITIATIVE, INC.
Practice address
155 Northpoint Ave
Ste 101
High Point, NC 27262-7738
Phone
(336) 884-8840
Fax
(336) 884-8842
NPI assigned
Dec 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. J Graham Reaves, PH.D.,CCAS,CCS
Title
President
Phone
(336) 884-8840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X MHL-041-737 NC Primary

Addresses

Primary practice location

155 Northpoint Ave
Ste 101
High Point, NC 27262-7738

Mailing address

155 Northpoint Ave
Ste 101
High Point, NC 27262-7738
Phone (336) 884-8840

Other identifiers 3

IdentifierTypeStateIssuer
6005973MedicaidNC
6111908MedicaidNC
6110562MedicaidNC

National Provider Directory

National Provider Directory

Locations

155 Northpoint Ave
Ste 101
High Point, NC 27262
Phone (336) 884-8840

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275699985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 NORTHPOINT AVE",
            "address_2": "STE 101",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627738",
            "telephone_number": "336-884-8840",
            "fax_number": "336-884-8842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 NORTHPOINT AVE",
            "address_2": "STE 101",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627738",
            "telephone_number": "336-884-8840",
            "fax_number": "336-884-8842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUILFORD YOUTH INITIATIVE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REAVES",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "GRAHAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-884-8840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D.,CCAS,CCS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "MHL-041-737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005973",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6111908",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6110562",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.