New Youth Program

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

NEW YOUTH PROGRAM

Practice address

121 Washington Ave N
Minneapolis, MN 55401-2503

Phone

(763) 501-5717

NPI assigned

Jun 21, 2022

Organization subpart

No

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

Authorized official

Name

Larcina Bryant

Title

Executive Director

Phone

(763) 501-5717

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655769600000",
    "number": "1326779257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 WASHINGTON AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 WASHINGTON AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012503",
            "telephone_number": "763-501-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YOUTH PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "LARCINA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "763-501-5717"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "DirectMessaging",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "121 Washington Ave N",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554012503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• New Salem Metamorphosis Adolesent Program
• New Salem Metormorphosis Youth Program
• New Salem Missionary Baptist Church
• New Vision Mental Health Inc
• New Visions School
• Alexis Marie Newberry, MD
• Ashley Marie Newberry, M.D.
• Tamar Katherine Newberry, M.D.
• Caroline Newbery
• Jean Rae Newby-Lovelace

• Case Management Agency in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Case Management Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.