NPIMap

Organization Active NPI

Youth Opportunities Incorporated

  • Community/Behavioral Health Agency
  • Winston Salem, NC
National Provider Identifier
1295954899
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL-034-214 Issued in NC
Legal business name
YOUTH OPPORTUNITIES INCORPORATED
Practice address
1401 Clemmonsville Road
Winston-Salem, NC 27127-5915
Phone
(336) 724-1412
Fax
(336) 724-1464
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Authorized official

Name
Ms. Ashley Conrad
Title
President & Ceo
Phone
(336) 724-1412

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X MHL-034-214 NC
Community/Behavioral Health Agency 251S00000X MHL-034-214 NC Primary

Addresses

Primary practice location

1401 Clemmonsville Road
Winston-Salem, NC 27127-5915

Mailing address

7670 N Point CT
Winston Salem, NC 27106-3336
Phone (336) 724-1412

Other identifiers 1

IdentifierTypeStateIssuer
8302570MedicaidNC

Other names 1

  • Griffith Middle Day Tx Other name

National Provider Directory

National Provider Directory
Tax ID family
Youth Opportunities Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

1401 W Clemmonsville Rd
Winston Salem, NC 27127
Phone (336) 771-4580

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450310400000",
    "number": "1295954899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7670 N POINT CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063336",
            "telephone_number": "336-724-1412",
            "fax_number": "336-724-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 CLEMMONSVILLE ROAD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271275915",
            "telephone_number": "336-724-1412",
            "fax_number": "336-724-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH OPPORTUNITIES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2015-12-17",
        "status": "A",
        "authorized_official_last_name": "CONRAD",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "336-724-1412",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "MHL-034-214",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-034-214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302570",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Griffith Middle Day Tx",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; 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.