NPIMap

Organization Active NPI

Changing Fazes Youth & Family Services, Inc.

  • Community/Behavioral Health Agency
  • Richmond, VA
National Provider Identifier
1740366566
Registry record updated Aug 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
572 Issued in VA
Legal business name
CHANGING FAZES YOUTH & FAMILY SERVICES, INC.
Practice address
2025 E Main St
Suite 212
Richmond, VA 23223-7069
Phone
(804) 344-3730
Fax
(804) 344-3731
NPI assigned
Oct 27, 2006
Last updated
Aug 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2009

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

Authorized official

Name
Mrs. Shenita Williams, LCSWNPI 1407993439
Title
Program Director
Phone
(804) 344-3730

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 572 VA Primary

Addresses

Primary practice location

2025 E Main St
Suite 212
Richmond, VA 23223-7069

Mailing address

2025 E Main St
Suite 212
Richmond, VA 23223-7069
Phone (804) 344-3730

Other identifiers 1

IdentifierTypeStateIssuer
010003393MedicaidVA

National Provider Directory

National Provider Directory
Tax ID family
Changing Fazes Youth Family Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2025 E Main St
Ste 212
Richmond, VA 23223
Phone (804) 344-3730

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249862400000",
    "number": "1740366566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 E MAIN ST",
            "address_2": "SUITE 212",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232237069",
            "telephone_number": "804-344-3730",
            "fax_number": "804-344-3731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 E MAIN ST",
            "address_2": "SUITE 212",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232237069",
            "telephone_number": "804-344-3730",
            "fax_number": "804-344-3731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING FAZES YOUTH & FAMILY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2009-08-10",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "SHENITA",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "804-344-3730",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010003393",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; 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.