Southeast Alabama Youth Services, Inc

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

SOUTHEAST ALABAMA YOUTH SERVICES, INC

Practice address

76 Victoria St
Louisville, AL 36048-3525

Phone

(334) 714-2549

NPI assigned

Aug 15, 2022

Last updated

Aug 15, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samantha Danielle Gordon

Title

Program Director

Phone

(334) 983-8377

Specialties & licenses 1

Addresses

Electronic endpoints 1

Tax ID family

Southeast Alabama Youth Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Southeast Alabama Youth Services

  • Professional Counselor
  • Dothan, AL
  • NPI 1790575256
  NPD tax ID
• Southeast Alabama Youth Services, Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Dothan, AL
  • NPI 1710084876
  NPD tax ID

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1760100804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2856 HORACE SHEPARD DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031007",
            "telephone_number": "334-714-2549",
            "fax_number": "334-983-1289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 VICTORIA ST",
            "city": "LOUISVILLE",
            "state": "AL",
            "postal_code": "360483525",
            "telephone_number": "334-714-2549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST ALABAMA YOUTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "DANIELLE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "334-983-8377"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sngordon@saysdothan.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "76 Victoria St",
            "city": "Louisville",
            "state": "AL",
            "country_code": "US",
            "postal_code": "360483525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melea Faith Brooks
• Johna Gayle Cotton, C.R.N.P.
• Kadrinne Kashun Johnson
• Quest Counseling Agency, LLC
• Southeast Alabama Regional Healthcare Authority (MCB Family Clinic)
• The Health Care Authority of the City of Eufaula (MCB Family Clinic)
• Town of Louisville (Louisville Ambulance Service)

• Professional Counselor in Louisville, AL
• Providers in Louisville, AL by specialty
• Professional Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.