NPIMap

Organization Active NPI

From the Desk of Dr. Yancey LLC

  • Mental Health Counselor
  • Suffolk, VA
National Provider Identifier
1619527645
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
FROM THE DESK OF DR. YANCEY LLC
Practice address
4897 Bennetts Pasture Rd #5354
Suffolk, VA 23435-2689
Phone
(888) 663-2475
Fax
(888) 663-2475
NPI assigned
Sep 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Authorized official

Name
Dr. Tiffinee Yancey, LPC
Title
Clinical Specialist
Phone
(757) 717-9569

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

4897 Bennetts Pasture Rd #5354
Suffolk, VA 23435-2689

Mailing address

PO Box 5354
Suffolk, VA 23435-0354
Phone (888) 663-2475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240430002209 VA Part B Supplier - Clinic/Group Practice 0042650657 Receives reassigned benefits from 6 practitioners
Practice locations: Suffolk, VA

National Provider Directory

National Provider Directory

Locations

4897 Bennetts Pasture Rd
Unit 5354
Suffolk, VA 23435
Phone (757) 589-7230

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": "1568160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1619527645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5354",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234350354",
            "telephone_number": "888-663-2475",
            "fax_number": "888-663-2475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4897 BENNETTS PASTURE RD #5354",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352689",
            "telephone_number": "888-663-2475",
            "fax_number": "888-663-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FROM THE DESK OF DR. YANCEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-11",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "YANCEY",
        "authorized_official_first_name": "TIFFINEE",
        "authorized_official_title_or_position": "CLINICAL SPECIALIST",
        "authorized_official_telephone_number": "757-717-9569",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.