Structures Youth Home Inc

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

SS-149-05 Issued in VA

Legal business name

STRUCTURES YOUTH HOME INC

Practice address

646 Holly Corner Rd
Fredericksburg, VA 22406-5308

Phone

(540) 752-0013

Fax

(540) 752-1147

NPI assigned

Jun 9, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Kathleen Ann Fitzsimmons, PSY.DNPI 1962679506

Title

Cao/Clinical Director

Phone

(540) 663-0574

Specialties & licenses 1

Addresses

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.

• Kathleen Ann Fitzsimmons, PSYD LPC

  • Professional Counselor
  • King George, VA
  • NPI 1962679506
  Authorized official Same address or phone

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1528228079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 149",
            "city": "DAHLGREN",
            "state": "VA",
            "postal_code": "224480149",
            "telephone_number": "540-663-0574",
            "fax_number": "540-663-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 HOLLY CORNER RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224065308",
            "telephone_number": "540-752-0013",
            "fax_number": "540-752-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRUCTURES YOUTH HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "FITZSIMMONS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CAO/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "540-663-0574",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "VA",
            "license": "SS-149-05",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgena H Strawderman
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• Skylar Strunk
• Kaylee Sturans
• Douglas Sturm, DO
• Sujith Subramonian Potty, P.T., MSRS.
• Sarah Katherine Suddes, DPT, PT

• Mental Illness Community Based Residential Treatment Facility in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Mental Illness Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.