NPIMap

Organization Active NPI

Youths' Hope Licensed Clinical Social Worker Inc

Doing business as Youth Hope Inc

  • Clinical Social Worker
  • San Bernardino, CA
National Provider Identifier
1770845497
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 18357 Issued in CA
Legal business name
YOUTHS' HOPE LICENSED CLINICAL SOCIAL WORKER INC
Doing business as
Youth Hope Inc
Practice address
255 N. D Street,
Suite 400
San Bernardino, CA 92401
Phone
(909) 567-2808
Fax
(909) 567-2808
NPI assigned
Jun 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Authorized official

Name
Dr. Geoffrey Bestman Ibeabuchi, PHD, LCSWNPI 1932241635
Title
Ceo
Phone
(909) 567-2808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X LCS 18357 CA Primary

Addresses

Primary practice location

255 N. D Street,
Suite 400
San Bernardino, CA 92401

Mailing address

PO Box 264
Pattom, CA 92369-0264
Phone (909) 567-2808

Other names 2

  • YOUTH HOPE INC Doing business as
  • Youths' Hope Inc. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Youth Hope 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.

Practitioners & affiliated clinicians

Practitioners 1

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": "1339113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574812800000",
    "number": "1770845497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 264",
            "city": "PATTOM",
            "state": "CA",
            "postal_code": "923690264",
            "telephone_number": "909-567-2808",
            "fax_number": "909-567-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N. D STREET,",
            "address_2": "SUITE 400",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92401",
            "telephone_number": "909-567-2808",
            "fax_number": "909-567-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTHS' HOPE LICENSED CLINICAL SOCIAL WORKER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-08",
        "last_updated": "2019-11-27",
        "status": "A",
        "authorized_official_last_name": "IBEABUCHI",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "BESTMAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-567-2808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 18357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "YOUTH HOPE INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "YOUTH HOPE INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Youths' Hope Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.