NPIMap

Organization Active NPI

Youth Shelters and Family Services

  • Professional Counselor
  • Santa Fe, NM
National Provider Identifier
1508225749
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0090881 Issued in NM
Legal business name
YOUTH SHELTERS AND FAMILY SERVICES
Practice address
5686 B Agua Fria Street
Santa Fe, NM 87507
Phone
(505) 983-0586
Fax
(505) 424-0949
NPI assigned
Feb 16, 2016
Last updated
Feb 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Authorized official

Name
Mr. David Alan Block
Title
Executive Director
Phone
(505) 983-0586

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0090881 NM Primary

Addresses

Primary practice location

5686 B Agua Fria Street
Santa Fe, NM 87507

Mailing address

P.O. Box 28279
Santa Fe, NM 87592-8279
Phone (505) 983-0586

Other identifiers 1

IdentifierTypeStateIssuer
000B9298MedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
Youth Shelters12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

5686B Agua Fria St
Santa Fe, NM 87507
Phone 5059830586 ext. 110

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455580800000",
    "number": "1508225749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 28279",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875928279",
            "telephone_number": "505-983-0586",
            "fax_number": "505-424-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5686 B AGUA FRIA STREET",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "87507",
            "telephone_number": "505-983-0586",
            "fax_number": "505-424-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH SHELTERS AND FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-02-16",
        "status": "A",
        "authorized_official_last_name": "BLOCK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "505-983-0586",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0090881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000B9298",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.