NPIMap

Organization Active NPI

Youth Service Bureau of Rock Island Co.

  • Mental Health Counselor
  • Rock Island, IL
National Provider Identifier
1396922084
Registry record updated Jan 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
YOUTH SERVICE BUREAU OF ROCK ISLAND CO.
Practice address
4709 44TH St
Suite 5
Rock Island, IL 61201-7187
Phone
(309) 793-3460
Fax
(309) 732-0551
NPI assigned
Jan 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2008

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

Authorized official

Name
Mr. Richard J Connor, LCSWNPI 1780703462
Title
Executive Director
Phone
(309) 793-3460

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

4709 44TH St
Suite 5
Rock Island, IL 61201-7187

Mailing address

4709 44 Street
Rock Island, IL 61201
Phone (309) 793-3460

National Provider Directory

National Provider Directory

Locations

4709 44th St
Rock Island, IL 61201
Phone (309) 558-0258

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201219200000",
    "number": "1396922084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 44 STREET",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "61201",
            "telephone_number": "309-793-3460",
            "fax_number": "309-732-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 44TH ST",
            "address_2": "SUITE 5",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017187",
            "telephone_number": "309-793-3460",
            "fax_number": "309-732-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH SERVICE BUREAU OF ROCK ISLAND CO.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-25",
        "last_updated": "2008-01-25",
        "status": "A",
        "authorized_official_last_name": "CONNOR",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "309-793-3460",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; 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.