Active NPI
National Youth Advocate Program, Inc
- Community/Behavioral Health Agency
- Tucker, GA
National Provider Identifier
1649406877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- NATIONAL YOUTH ADVOCATE PROGRAM, INC
- Practice address
- 100 Crescent Center Pkwy Ste 680
Tucker, GA 30084-7061 - Phone
- (877) 490-6644
- Fax
- (404) 378-3423
- NPI assigned
- Jun 2, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Marvena Twigg
- Title
- President/Ceo
- Phone
- (614) 487-8758
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
100 Crescent Center Pkwy Ste 680
Tucker, GA 30084-7061
Mailing address
1801 Watermark Dr Ste 200
Columbus, OH 43215-7088
Phone (614) 487-8758
Other practice location 1
360 Furys Ferry Rd
Augusta, GA 30907-3045
Phone (706) 724-4387
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003179943A | Medicaid | GA |
National Provider Directory
National Provider Directory- Tax ID family
- National Youth Advocate Program
Locations
360 Furys Ferry Rd
Augusta, GA 30907
Phone (706) 724-4387
100 Crescent Center Pkwy
Ste 680
Tucker, GA 30084
Phone (404) 761-7997
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Community Health Worker
- Augusta, GA
- NPI 1477251346
-
- Mental Health Counselor
- Mount Vernon, IA
- NPI 1265130033
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243900800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1743724800000",
"number": "1649406877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 WATERMARK DR STE 200",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432157088",
"telephone_number": "614-487-8758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CRESCENT CENTER PKWY STE 680",
"city": "TUCKER",
"state": "GA",
"postal_code": "300847061",
"telephone_number": "877-490-6644",
"fax_number": "404-378-3423"
}
],
"practiceLocations": [
{
"address_1": "360 Furys Ferry Rd",
"address_purpose": "LOCATION",
"city": "Augusta",
"state": "GA",
"postal_code": "309073045",
"country_code": "US",
"telephone_number": "706-724-4387",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "NATIONAL YOUTH ADVOCATE PROGRAM, INC",
"organizational_subpart": "NO",
"enumeration_date": "2009-06-02",
"last_updated": "2025-04-04",
"certification_date": "2025-04-04",
"status": "A",
"authorized_official_last_name": "TWIGG",
"authorized_official_first_name": "MARVENA",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "614-487-8758"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003179943A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucker, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.