Apostolic Youth & Family Services

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20042301A Issued in IN

Legal business name

APOSTOLIC YOUTH & FAMILY SERVICES

Practice address

4645 Broadway
Gary, IN 46409-2461

Phone

(219) 981-4008

Fax

(219) 981-9273

NPI assigned

Jul 30, 2009

Last updated

Jul 30, 2009By 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

Mr. Clifton Smith, LCSWNPI 1417232414

Title

Executive Director

Phone

(219) 981-4008

Specialties & licenses 2

Addresses

Locations

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.

• Clifton Smith, LCSW

  • Clinical Social Worker
  • Gary, IN
  • NPI 1417232414
  NPD (past) Authorized official

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248912000000",
    "number": "1275764896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 BROADWAY",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464092461",
            "telephone_number": "219-981-4008",
            "fax_number": "219-981-9273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 BROADWAY",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464092461",
            "telephone_number": "219-981-4008",
            "fax_number": "219-981-9273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APOSTOLIC YOUTH & FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-30",
        "last_updated": "2009-07-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CLIFTON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "219-981-4008",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042301A",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34001842A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Gary, IN
• Providers in Gary, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; 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.